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Fifteen-year risk of major coronary events predicted by Holter ST-monitoring in asymptomatic middle-aged men.

Stagmo, Martin LU ; Juul-Möller, Steen LU and Israelsson, Bo LU (2005) In European Journal of Cardiovascular Prevention & Rehabilitation 12(5). p.478-483
Abstract
Background: Ambulatory electrocardiogram monitoring (Holter) with ST-analysis as a measure of myocardial ichemia has in populations with coronary heart disease been shown to predict major coronary events: death, myocardial infarction or coronary revascularization. There has, however, been conflicting evidence regarding the usefulness of this technique in identification of healthy subjects with increased risk for coronary heart disease. The aim of this study was to assess if Holter monitoring with ST-analysis could be used to predict future major coronary events in asymptomatic middle-aged men with a defined aggregation of traditional risk factors for coronary heart disease.



Methods: One hundred and fifty-five... (More)
Background: Ambulatory electrocardiogram monitoring (Holter) with ST-analysis as a measure of myocardial ichemia has in populations with coronary heart disease been shown to predict major coronary events: death, myocardial infarction or coronary revascularization. There has, however, been conflicting evidence regarding the usefulness of this technique in identification of healthy subjects with increased risk for coronary heart disease. The aim of this study was to assess if Holter monitoring with ST-analysis could be used to predict future major coronary events in asymptomatic middle-aged men with a defined aggregation of traditional risk factors for coronary heart disease.



Methods: One hundred and fifty-five asymptomatic participants from the city of Malmo, Sweden, with known levels of conventional cardiovascular risk factors underwent Holter monitoring for analysis of transient ST-segment depression at the age of 55 years. Fifteen years after the Holter monitoring, hospital records, diagnosis and death registries were revisited for major coronary events.



Results: An ST-segment depression of 1 mm or greater (0.1 mV) was considered significant for myocardial ischemia and was found in 54 of the 155 men. There were no significant differences in risk factors in the two groups at baseline. The 15-year incidence of a first major coronary event was significantly higher in men with ST-segment depression (39%) than in men without ST-segment depression (20%) (P<0.015). A Holter electrocardiogram could predict future major coronary events with a positive and negative predictive value of 35 and 80%, respectively.



Conclusions: Holter monitoring can be used as a complement to conventional risk factor evaluation in deciding whether or not to treat risk factors for CHD in asymptomatic subjects. (Less)
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type
Contribution to journal
publication status
published
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in
European Journal of Cardiovascular Prevention & Rehabilitation
volume
12
issue
5
pages
478 - 483
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000249264700010
  • scopus:33644875583
ISSN
1741-8275
language
English
LU publication?
yes
id
5086dde7-be1b-49e1-8065-78531f3177c7 (old id 144776)
alternative location
http://www.ejcpr.com/pt/re/ejcpr/abstract.00149831-200510000-00010.htm;jsessionid=GtrJ7RHCXg3g0jnZDC2g8KQvQ69Q1Xbv5gKvdpH8NvqwTdyv1xcJ!1683421839!181195628!8091!-1
date added to LUP
2007-07-30 15:41:19
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2017-04-09 03:41:44
@article{5086dde7-be1b-49e1-8065-78531f3177c7,
  abstract     = {Background: Ambulatory electrocardiogram monitoring (Holter) with ST-analysis as a measure of myocardial ichemia has in populations with coronary heart disease been shown to predict major coronary events: death, myocardial infarction or coronary revascularization. There has, however, been conflicting evidence regarding the usefulness of this technique in identification of healthy subjects with increased risk for coronary heart disease. The aim of this study was to assess if Holter monitoring with ST-analysis could be used to predict future major coronary events in asymptomatic middle-aged men with a defined aggregation of traditional risk factors for coronary heart disease.<br/><br>
<br/><br>
Methods: One hundred and fifty-five asymptomatic participants from the city of Malmo, Sweden, with known levels of conventional cardiovascular risk factors underwent Holter monitoring for analysis of transient ST-segment depression at the age of 55 years. Fifteen years after the Holter monitoring, hospital records, diagnosis and death registries were revisited for major coronary events.<br/><br>
<br/><br>
Results: An ST-segment depression of 1 mm or greater (0.1 mV) was considered significant for myocardial ischemia and was found in 54 of the 155 men. There were no significant differences in risk factors in the two groups at baseline. The 15-year incidence of a first major coronary event was significantly higher in men with ST-segment depression (39%) than in men without ST-segment depression (20%) (P&lt;0.015). A Holter electrocardiogram could predict future major coronary events with a positive and negative predictive value of 35 and 80%, respectively.<br/><br>
<br/><br>
Conclusions: Holter monitoring can be used as a complement to conventional risk factor evaluation in deciding whether or not to treat risk factors for CHD in asymptomatic subjects.},
  author       = {Stagmo, Martin and Juul-Möller, Steen and Israelsson, Bo},
  issn         = {1741-8275},
  language     = {eng},
  number       = {5},
  pages        = {478--483},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {European Journal of Cardiovascular Prevention & Rehabilitation},
  title        = {Fifteen-year risk of major coronary events predicted by Holter ST-monitoring in asymptomatic middle-aged men.},
  volume       = {12},
  year         = {2005},
}