Both minor and major ECG abnormalities linked with increased risk of cardiovascular events in women

Postmenopausal women without symptoms of cardiovascular problems who have minor or major abnormalities on an electrocardiogram are at increased risk for future cardiovascular events and death, according to a study in the March 7 issue of JAMA.

Resting 12-lead electrocardiogram (ECG) abnormalities are independently associated with incident coronary heart disease (CHD) and cardiovascular disease (CVD) events. Many prior studies included only men or compared men and women but the women were not selected for age or the presence or absence of underlying heart disease, according to background information in the article. Data are sparse regarding the prevalence, incidence, and independent prognostic value of minor and/or major electrocardiographic abnormalities in asymptomatic postmenopausal women. There is no information on the effect, if any, of hormonal treatment on the prognostic value of the ECG.

Pablo Denes, M.D., of the Feinberg School of Medicine, Northwestern University, Chicago, and colleagues conducted a study to examine the association of baseline and new ECG findings with CHD and CVD outcomes in the placebo and hormonal treatment groups of the Women's Health Initiative (WHI) estrogen plus progestin trial. This portion of the trial, which was stopped in July 2002, examined whether in healthy postmenopausal women this combination would reduce CHD and CVD events. The trial found that there was a significant increase in CHD rates among women taking hormone therapy compared with the placebo group.

The sample analyzed included 14,749 postmenopausal asymptomatic women with intact uterus who received 1 daily tablet containing 0.625 mg of oral conjugated equine estrogen and 2.5 mg of medroxyprogesterone acetate or a matching placebo. Participants were enrolled from 1993 to 1998.

The researchers found that among women with absent (n = 9,744), minor (n = 4,095), and major (n = 910) ECG abnormalities, there were 118, 91, and 37

Contact: Marla Paul
JAMA and Archives Journals

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