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Sökning: WFRF:(Nowak Jacek) > Hammar Niklas > Analysis of ST/HR h...

Analysis of ST/HR hysteresis improves long-term prognostic value of exercise ECG test.

Kronander, Håkan (författare)
KTH,Medicinsk teknik
Hammar, Niklas (författare)
Karolinska Institutet
Fischer-Colbrie, Werner (författare)
visa fler...
Nowak, Jacek (författare)
Karolinska Institutet
Brodin, Lars-Åke (författare)
KTH,Medicinsk teknik
Elmqvist, Håkan (författare)
KTH,Medicinsk teknik
visa färre...
 (creator_code:org_t)
Elsevier BV, 2011
2011
Engelska.
Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 148:1, s. 64-9
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BACKGROUND: ST/HR hysteresis is one of the better diagnostic exercise ECG variables for coronary artery disease. This study evaluates the long-term prognostic value of ST/HR hysteresis in predicting acute myocardial infarction (AMI) and all-cause mortality in men and women. METHODS: The study population consisted of 8317 patients who had undergone routine exercise test on bicycle ergometer at one Swedish centre. Information on AMI and all-cause mortality was obtained from national Swedish registers covering a mean follow-up period of 9.5 years. RESULTS: The adjusted hazard ratio for AMI at a diagnostic cut point of ≤-20 µV for ST/HR hysteresis was 1.88 (95% CI, 1.62-2.17) in men and 2.31 (95% CI, 1.83-2.91) in women. For all-cause death the adjusted hazard ratio was 1.72 (95% CI, 1.52-1.96) in men and 1.90 (95% CI, 1.57-2.29) in women. The corresponding hazard ratios for ST-segment depression with horizontal or down-sloping ST-segment, ST-segment depression, ST/HR index, and ST/HR slope were lower. For comparison, the adjusted hazard ratio for AMI using maximal workload in percent of predicted was 2.02 (95% CI, 1.77-2.32) in men and 2.14 (95% CI, 1.71-2.67) in women. Area under the ROC curves for prediction of AMI was significantly larger using ST/HR hysteresis than using any of three other evaluated ECG indicators. CONCLUSIONS: ST/HR hysteresis appears to improve the prognostic ability of an exercise ECG test for AMI and all-cause mortality in a long-term perspective compared to conventional ST-segment and ST/HR indicators in both genders and clearly more markedly in women.

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