Cumulative impact of axial, structural, and repolarization ECG findings on long-term cardiovascular mortality among healthy individuals in Japan

National Integrated Project for Prospective Observation of Non-Communicable Disease and its Trends in the Aged, 1980 and 1990

Taku Inohara, Shun Kosaka, Tomonori Okamura, Makoto Watanabe, Yasuyuki Nakamura, Aya Higashiyama, Aya Kadota, Nagako Okuda, Yoshitaka Murakami, Takayoshi Ohkubo, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Methods and Results: Community-dwelling Japanese residents from the National Integrated Project for Perspective Observation of Non-Communicable Disease and its Trends in the Aged, 1980-2004 and 1990-2005 (NIPPON DATA80 and 90), were included in this study. Baseline ECG findings were classified using the Minnesota Code and categorized into axial (left axis deviation, clockwise rotation), structural (left ventricular hypertrophy, atrial enlargement), and repolarization (minor and major ST-T changes) abnormalities. The hazard ratios of the cumulative impacts of ECG findings on long-term CVD death were estimated by stratified Cox proportional hazard models, including adjustments for cohort strata. In all, 16,816 participants were evaluated. The average age was 51.2 ±13.5 years; 42.7% participants were male. The duration of follow up was 300,924 person-years (mean 17.9±5.8 years); there were 1218 CVD deaths during that time. Overall, 4203 participants (25.0%) had one or more categorical ECG abnormalities: 3648 (21.7%) had a single abnormality, and 555 (3.3%) had two or more. The risk of CVD mortality increased as the number of abnormalities accumulated (single abnormality HR 1.29, 95% CI 1.13-1.48; ≥2 abnormalities HR 2.10, 95% CI 1.73-2.53).

Conclusions: Individual ECG abnormalities had an additive effect in predicting CVD outcome risk in our large-scale cohort study.

Aims: Various cohort studies have shown a close association between long-term cardiovascular disease (CVD) outcomes and individual electrocardiographic (ECG) abnormalities such as axial, structural, and repolarization changes. The combined effect of these ECG abnormalities, each assumed to be benign, has not been thoroughly investigated.

Original languageEnglish
Pages (from-to)1501-1508
Number of pages8
JournalEuropean Journal of Preventive Cardiology
Volume21
Issue number12
DOIs
Publication statusPublished - 2014 Dec 24

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Japan
Cardiovascular Diseases
Observation
Mortality
Cohort Studies
Independent Living
Left Ventricular Hypertrophy
Proportional Hazards Models

Keywords

  • Cardiovascular outcomes
  • cohort study
  • electrocardiography
  • NIPPON DATA80
  • NIPPON DATA90

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology

Cite this

Cumulative impact of axial, structural, and repolarization ECG findings on long-term cardiovascular mortality among healthy individuals in Japan : National Integrated Project for Prospective Observation of Non-Communicable Disease and its Trends in the Aged, 1980 and 1990. / Inohara, Taku; Kosaka, Shun; Okamura, Tomonori; Watanabe, Makoto; Nakamura, Yasuyuki; Higashiyama, Aya; Kadota, Aya; Okuda, Nagako; Murakami, Yoshitaka; Ohkubo, Takayoshi; Miura, Katsuyuki; Okayama, Akira; Ueshima, Hirotsugu.

In: European Journal of Preventive Cardiology, Vol. 21, No. 12, 24.12.2014, p. 1501-1508.

Research output: Contribution to journalArticle

Inohara, Taku ; Kosaka, Shun ; Okamura, Tomonori ; Watanabe, Makoto ; Nakamura, Yasuyuki ; Higashiyama, Aya ; Kadota, Aya ; Okuda, Nagako ; Murakami, Yoshitaka ; Ohkubo, Takayoshi ; Miura, Katsuyuki ; Okayama, Akira ; Ueshima, Hirotsugu. / Cumulative impact of axial, structural, and repolarization ECG findings on long-term cardiovascular mortality among healthy individuals in Japan : National Integrated Project for Prospective Observation of Non-Communicable Disease and its Trends in the Aged, 1980 and 1990. In: European Journal of Preventive Cardiology. 2014 ; Vol. 21, No. 12. pp. 1501-1508.
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abstract = "Methods and Results: Community-dwelling Japanese residents from the National Integrated Project for Perspective Observation of Non-Communicable Disease and its Trends in the Aged, 1980-2004 and 1990-2005 (NIPPON DATA80 and 90), were included in this study. Baseline ECG findings were classified using the Minnesota Code and categorized into axial (left axis deviation, clockwise rotation), structural (left ventricular hypertrophy, atrial enlargement), and repolarization (minor and major ST-T changes) abnormalities. The hazard ratios of the cumulative impacts of ECG findings on long-term CVD death were estimated by stratified Cox proportional hazard models, including adjustments for cohort strata. In all, 16,816 participants were evaluated. The average age was 51.2 ±13.5 years; 42.7{\%} participants were male. The duration of follow up was 300,924 person-years (mean 17.9±5.8 years); there were 1218 CVD deaths during that time. Overall, 4203 participants (25.0{\%}) had one or more categorical ECG abnormalities: 3648 (21.7{\%}) had a single abnormality, and 555 (3.3{\%}) had two or more. The risk of CVD mortality increased as the number of abnormalities accumulated (single abnormality HR 1.29, 95{\%} CI 1.13-1.48; ≥2 abnormalities HR 2.10, 95{\%} CI 1.73-2.53).Conclusions: Individual ECG abnormalities had an additive effect in predicting CVD outcome risk in our large-scale cohort study.Aims: Various cohort studies have shown a close association between long-term cardiovascular disease (CVD) outcomes and individual electrocardiographic (ECG) abnormalities such as axial, structural, and repolarization changes. The combined effect of these ECG abnormalities, each assumed to be benign, has not been thoroughly investigated.",
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T1 - Cumulative impact of axial, structural, and repolarization ECG findings on long-term cardiovascular mortality among healthy individuals in Japan

T2 - National Integrated Project for Prospective Observation of Non-Communicable Disease and its Trends in the Aged, 1980 and 1990

AU - Inohara, Taku

AU - Kosaka, Shun

AU - Okamura, Tomonori

AU - Watanabe, Makoto

AU - Nakamura, Yasuyuki

AU - Higashiyama, Aya

AU - Kadota, Aya

AU - Okuda, Nagako

AU - Murakami, Yoshitaka

AU - Ohkubo, Takayoshi

AU - Miura, Katsuyuki

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

PY - 2014/12/24

Y1 - 2014/12/24

N2 - Methods and Results: Community-dwelling Japanese residents from the National Integrated Project for Perspective Observation of Non-Communicable Disease and its Trends in the Aged, 1980-2004 and 1990-2005 (NIPPON DATA80 and 90), were included in this study. Baseline ECG findings were classified using the Minnesota Code and categorized into axial (left axis deviation, clockwise rotation), structural (left ventricular hypertrophy, atrial enlargement), and repolarization (minor and major ST-T changes) abnormalities. The hazard ratios of the cumulative impacts of ECG findings on long-term CVD death were estimated by stratified Cox proportional hazard models, including adjustments for cohort strata. In all, 16,816 participants were evaluated. The average age was 51.2 ±13.5 years; 42.7% participants were male. The duration of follow up was 300,924 person-years (mean 17.9±5.8 years); there were 1218 CVD deaths during that time. Overall, 4203 participants (25.0%) had one or more categorical ECG abnormalities: 3648 (21.7%) had a single abnormality, and 555 (3.3%) had two or more. The risk of CVD mortality increased as the number of abnormalities accumulated (single abnormality HR 1.29, 95% CI 1.13-1.48; ≥2 abnormalities HR 2.10, 95% CI 1.73-2.53).Conclusions: Individual ECG abnormalities had an additive effect in predicting CVD outcome risk in our large-scale cohort study.Aims: Various cohort studies have shown a close association between long-term cardiovascular disease (CVD) outcomes and individual electrocardiographic (ECG) abnormalities such as axial, structural, and repolarization changes. The combined effect of these ECG abnormalities, each assumed to be benign, has not been thoroughly investigated.

AB - Methods and Results: Community-dwelling Japanese residents from the National Integrated Project for Perspective Observation of Non-Communicable Disease and its Trends in the Aged, 1980-2004 and 1990-2005 (NIPPON DATA80 and 90), were included in this study. Baseline ECG findings were classified using the Minnesota Code and categorized into axial (left axis deviation, clockwise rotation), structural (left ventricular hypertrophy, atrial enlargement), and repolarization (minor and major ST-T changes) abnormalities. The hazard ratios of the cumulative impacts of ECG findings on long-term CVD death were estimated by stratified Cox proportional hazard models, including adjustments for cohort strata. In all, 16,816 participants were evaluated. The average age was 51.2 ±13.5 years; 42.7% participants were male. The duration of follow up was 300,924 person-years (mean 17.9±5.8 years); there were 1218 CVD deaths during that time. Overall, 4203 participants (25.0%) had one or more categorical ECG abnormalities: 3648 (21.7%) had a single abnormality, and 555 (3.3%) had two or more. The risk of CVD mortality increased as the number of abnormalities accumulated (single abnormality HR 1.29, 95% CI 1.13-1.48; ≥2 abnormalities HR 2.10, 95% CI 1.73-2.53).Conclusions: Individual ECG abnormalities had an additive effect in predicting CVD outcome risk in our large-scale cohort study.Aims: Various cohort studies have shown a close association between long-term cardiovascular disease (CVD) outcomes and individual electrocardiographic (ECG) abnormalities such as axial, structural, and repolarization changes. The combined effect of these ECG abnormalities, each assumed to be benign, has not been thoroughly investigated.

KW - Cardiovascular outcomes

KW - cohort study

KW - electrocardiography

KW - NIPPON DATA80

KW - NIPPON DATA90

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