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Open AccessResearch article

The association of spatial T wave axis deviation with incident coronary events. The ARIC cohort

Georgeta D Vaidean1 email, Pentti M Rautaharju2 email, Ronald J Prineas2 email, Eric A Whitsel3 email, Lloyd E Chambless4 email, Aaron R Folsom5 email, Wayne D Rosamond1 email, Zhu-Ming Zhang2 email, Richard S Crow5 email and Gerardo Heiss1 email

Department of Epidemiology, University of North Carolina at Chapel Hill, USA

Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

Department of Epidemiology and Department of Medicine, University of North Carolina at Chapel Hill, USA

Department of Biostatistics, University of North Carolina at Chapel Hill, USA

Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA

author email corresponding author email

BMC Cardiovascular Disorders 2005, 5:2doi:10.1186/1471-2261-5-2

Published: 11 January 2005

Abstract

Background

Although current evidence suggests that the spatial T wave axis captures important information about ventricular repolarization abnormalities, there are only a few and discordant epidemiologic studies addressing the ability of the spatial T wave axis to predict coronary heart disease (CHD) occurrence.

Methods

This prospective study analyzed data from 12,256 middle-aged African American and white men and women, from the Atherosclerosis Risk in Communities Study (ARIC). Following a standardized protocol, resting standard 12-lead, 10-second electrocardiograms were digitized and analyzed with the Marquette GE program. The median follow-up time was 12.1 years; incident coronary heart disease comprised fatal and non-fatal CHD events.

Results

The incidence rate of CHD was 4.26, 4.18, 4.28 and 5.62 per 1000 person-years respectively, across the spatial T wave axis quartiles. Among women for every 10 degrees increase in the spatial T wave axis deviation, there was an estimated increase in the risk of CHD of 1.16 (95% CI 1.04–1.28). After adjustment for age, height, weight, smoking, hypertension, diabetes, QRS axis and minor T wave abnormalities, this hazard rate ratio for women fell to 1.03 (0.92–1.14). The corresponding crude and adjusted hazard ratios for men were 1.05 (95% CI 0.96–1.15) and 0.95 (0.86–1.04) respectively.

Conclusions

In conclusion, this prospective, population-based, bi-ethnic study of men and women free of coronary heart disease at baseline shows that spatial T wave axis deviation is not associated with incident coronary events during long-term follow up. It is doubtful that spatial T wave axis deviation would add benefit in the prediction of CHD events above and beyond the current traditional risk factors.


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