Rautaharju Pentti M, Ge Sijian, Nelson Jennifer C, Marino Larsen Emily K, Psaty Bruce M, Furberg Curt D, Zhang Zhu-Ming, Robbins John, Gottdiener John S, Chaves Paulo H M
The Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina, USA.
Am J Cardiol. 2006 Feb 1;97(3):309-15. doi: 10.1016/j.amjcard.2005.08.046. Epub 2005 Dec 1.
Mortality risk associated with electrocardiographic (ECG) abnormalities has been commonly reported to be lower in women than in men. We compared coronary heart disease (CHD) and all-cause mortality risk for ECG variables during a mean 9.1-year follow-up in 4,912 participants in the Cardiovascular Health Study who were > or = 65 years of age. The hypothesis was that mortality risk for ECG abnormalities is not lower in women than in men. Five ECG variables were significant mortality predictors in Cox regression models that were adjusted for demographic, clinical, and medication variables. Gender differences were significant and mortality risk was higher in women for ECG estimates of left ventricular mass for both end points and for nondipolar QRS voltage for all-cause mortality. When evaluated simultaneously in multiple ECG variable risk models in subgroups that were stratified by baseline CHD status, no gender difference was significant. In the latter models, ST depression was a strong predictor of CHD mortality in groups with and without previous CHD. Other significant ECG predictors were previous myocardial infarction in the previous CHD group and nondipolar QRS voltage in the CHD-free group. Four ECG abnormalities were significant predictors of all-cause mortality in the CHD-free group, with risk increases of 18% to 50%. The risk of all-cause mortality in the previous CHD group was significantly increased for ST depression (by 64%), the ECG estimate of left ventricular mass (by 48%), and previous myocardial infarction (by 34%). In conclusion, we found no evidence that the relative risk of mortality for ECG abnormalities is lower in women than in men.
据普遍报道，心电图（ECG）异常相关的死亡风险在女性中低于男性。我们比较了心血管健康研究中4912名年龄≥65岁参与者在平均9.1年随访期间，心电图变量与冠心病（CHD）及全因死亡风险的关系。我们的假设是，心电图异常的死亡风险在女性中并不低于男性。在对人口统计学、临床和用药变量进行校正的Cox回归模型中，五个心电图变量是显著的死亡预测因子。性别差异显著，两个终点的左心室质量心电图评估以及全因死亡的非双极QRS电压方面，女性的死亡风险更高。在按基线冠心病状态分层的亚组中，在多个心电图变量风险模型中同时评估时，未发现显著的性别差异。在这些模型中，ST段压低是有或无既往冠心病组中冠心病死亡的强预测因子。其他显著的心电图预测因子在既往冠心病组中是既往心肌梗死，在无冠心病组中是非双极QRS电压。在无冠心病组中，四种心电图异常是全因死亡的显著预测因子，风险增加18%至50%。在既往冠心病组中，ST段压低（增加64%）、左心室质量心电图评估（增加48%）和既往心肌梗死（增加34%）使全因死亡风险显著增加。总之，我们没有发现证据表明心电图异常的相对死亡风险在女性中低于男性。
