Document Detail


Prognostic associations of Minnesota Code serial electrocardiographic change classification with coronary heart disease mortality in the Multiple Risk Factor Intervention Trial.
MedLine Citation:
PMID:  9230148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A central requirement for epidemiologic studies and clinical trials is a bias-free, objective determination of cardiac incidence rates between comparison groups. Epidemiologic studies and clinical trials frequently use changes in the Minnesota Code to document incident ischemic events. An electrocardiographic (ECG) classification system was developed to document significant ECG pattern change using objective comparison rules for side-by-side annual ECG comparison. Previously, we showed that major evolving Q waves were strongly and independently associated with total and coronary disease mortality. Using baseline-to-annual ECG comparisons in the Multiple Risk Factor Intervention Trial, we evaluated major evolving Q waves, minor evolving Q waves combined with major evolving ST-T waves and major evolving ST-T waves alone for their prognostic associations with coronary, cardiovascular, and total mortality during 16 years of follow-up. The 16-year coronary mortality rate in men with evolving minor Q waves plus evolving ST-T waves had an average adjusted relative risk of 4, equivalent to that of a major evolving Q wave. These risk ratios held whether a clinical infarction had occurred. Silent evolving ST-T waves without Q-wave change had an average adjusted relative coronary mortality risk of 1.6. Serial comparison methodology documents additional incident ischemic ECG events beyond the traditional major Minnesota Q-code change used in older epidemiologic studies. The procedure is standardized, quantitative, and repeatable. It is applicable for any study, present or past, that used Minnesota coding. The method is also well suited for incorporation in computer analysis programs.
Authors:
R S Crow; R J Prineas; P J Hannan; G Grandits; H Blackburn
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  80     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-08-07     Completed Date:  1997-08-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  138-44     Citation Subset:  AIM; IM    
Affiliation:
Division of Epidemiology, University of Minnesota, Minneapolis 55454-1015, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiovascular Diseases / mortality
Cause of Death
Coronary Disease / diagnosis*,  mortality*
Electrocardiography / classification*,  standards
Epidemiologic Methods
Humans
Male
Middle Aged
Prognosis
Randomized Controlled Trials as Topic
Grant Support
ID/Acronym/Agency:
R01HL2987/HL/NHLBI NIH HHS

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