Document Detail

Asymptomatic ST-segment depression during exercise testing and the risk of sudden cardiac death in middle-aged men: a population-based follow-up study.
MedLine Citation:
PMID:  19168533     Owner:  NLM     Status:  MEDLINE    
AIMS: Silent electrocardiographic ST change predicts future coronary events in patients with coronary heart disease (CHD), but the prognostic significance of asymptomatic ST-segment depression with respect to sudden cardiac death in subjects without apparent CHD is not well known.
METHODS AND RESULTS: We investigated the association between silent ST-segment depression during and after maximal symptom-limited exercise test and the risk of sudden cardiac death in a population-based sample of 1769 men without evident CHD. A total of 72 sudden cardiac death occurred during the median follow-up of 18 years. The risk of sudden cardiac death was increased among men with asymptomatic ST-segment depression during exercise [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.2-3.9] as well as among those with asymptomatic ST-segment depression during recovery period (HR 3.2, 95% CI 1.7-6.0). Asymptomatic ST-depression during exercise testing was a stronger predictor for the risk of sudden cardiac death especially among smokers as well as in hypercholesterolaemic and hypertensive men than in men without these risk factors.
CONCLUSION: Asymptomatic ST-segment depression was a very strong predictor of sudden cardiac death in men with any conventional risk factor but no previously diagnosed CHD, emphasizing the value of exercise testing to identify asymptomatic high-risk men who could benefit from preventive measures.
Jari A Laukkanen; Timo H Mäkikallio; Rainer Rauramaa; Sudhir Kurl
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-01-23
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-02     Completed Date:  2009-04-01     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  558-65     Citation Subset:  IM    
Research Institute of Public Health, University of Kuopio, Kuopio, Finland.
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MeSH Terms
Body Mass Index
Death, Sudden, Cardiac / epidemiology,  etiology*
Diabetes Mellitus, Type 2 / complications,  epidemiology,  physiopathology
Epidemiologic Methods
Exercise / physiology*
Exercise Test / methods
Finland / epidemiology
Hypertension / complications,  epidemiology
Middle Aged
Smoking / adverse effects,  epidemiology
Grant Support
Comment In:
Eur Heart J. 2009 Mar;30(5):528-9   [PMID:  19201762 ]

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