Interactive effects of ST-T wave abnormalities on survival of patients with coronary artery disease

James H. Crenshaw, David M. Mirvis, Faten El-Zeky, Roger Vander Zwaag, K Ramanathan, Virginia Maddock, Frank H. Kroetz, Jay M. Sullivan

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Previous studies have documented a reduced survival time in patients with an electrocardiographic (ECG) ST-T wave abnormality. This study was designed to determine the clinical, hemodynamic and angiographic correlates of this observation. Data from 9,731 patients undergoing cardiac catheterization from 1976 through 1986 were analyzed; 5,531 had severe (>70%) obstruction of at least one major coronary artery, 1,706 had mild (10 to 69%) obstruction and 2,494 had no obstruction. Of the patients with severe obstruction, 2,536 were treated medically and 2,995 were treated by surgical revascularization. Patients with an ST-T abnormality had more clinical risk factors (including older age and greater prevalence of diabetes mellitus, hypertension and prior myocardial infarction) and greater left ventricular dysfunction (including higher end-diastolic pressure and ventricular volume, reduced ejection fraction and greater prevalence of contraction abnormality) than did those without this ECG pattern. Survival time was significantly (p < 0.01) reduced in subsets of patients with an ST-T abnormality and with severe or mild coronary artery disease; in those without coronary disease, ST-T changes did not correlate with reduced survival. Stepwise regression analysis was applied to each group to determine the independent predictors of 5-year survival. In patients with severe disease or no disease, an ST-T abnormality was not chosen as an independent predictor of 5-year survival; in the group with mild disease, ST-T changes were an independent predictor of reduced survival. Thus, the independent impact of an ST-T abnormality on survival is dependent on the severity of underlying coronary artery disease.

Original languageEnglish (US)
Pages (from-to)413-420
Number of pages8
JournalJournal of the American College of Cardiology
Volume18
Issue number2
DOIs
StatePublished - Jan 1 1991

Fingerprint

Coronary Artery Disease
Survival
Left Ventricular Dysfunction
Cardiac Catheterization
Stroke Volume
Coronary Disease
Coronary Vessels
Diabetes Mellitus
Hemodynamics
Myocardial Infarction
Regression Analysis
Blood Pressure
Hypertension

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Interactive effects of ST-T wave abnormalities on survival of patients with coronary artery disease. / Crenshaw, James H.; Mirvis, David M.; El-Zeky, Faten; Zwaag, Roger Vander; Ramanathan, K; Maddock, Virginia; Kroetz, Frank H.; Sullivan, Jay M.

In: Journal of the American College of Cardiology, Vol. 18, No. 2, 01.01.1991, p. 413-420.

Research output: Contribution to journalArticle

Crenshaw, James H. ; Mirvis, David M. ; El-Zeky, Faten ; Zwaag, Roger Vander ; Ramanathan, K ; Maddock, Virginia ; Kroetz, Frank H. ; Sullivan, Jay M. / Interactive effects of ST-T wave abnormalities on survival of patients with coronary artery disease. In: Journal of the American College of Cardiology. 1991 ; Vol. 18, No. 2. pp. 413-420.
@article{7ffe4f0f86ba4e1587b368df3334b5c8,
title = "Interactive effects of ST-T wave abnormalities on survival of patients with coronary artery disease",
abstract = "Previous studies have documented a reduced survival time in patients with an electrocardiographic (ECG) ST-T wave abnormality. This study was designed to determine the clinical, hemodynamic and angiographic correlates of this observation. Data from 9,731 patients undergoing cardiac catheterization from 1976 through 1986 were analyzed; 5,531 had severe (>70{\%}) obstruction of at least one major coronary artery, 1,706 had mild (10 to 69{\%}) obstruction and 2,494 had no obstruction. Of the patients with severe obstruction, 2,536 were treated medically and 2,995 were treated by surgical revascularization. Patients with an ST-T abnormality had more clinical risk factors (including older age and greater prevalence of diabetes mellitus, hypertension and prior myocardial infarction) and greater left ventricular dysfunction (including higher end-diastolic pressure and ventricular volume, reduced ejection fraction and greater prevalence of contraction abnormality) than did those without this ECG pattern. Survival time was significantly (p < 0.01) reduced in subsets of patients with an ST-T abnormality and with severe or mild coronary artery disease; in those without coronary disease, ST-T changes did not correlate with reduced survival. Stepwise regression analysis was applied to each group to determine the independent predictors of 5-year survival. In patients with severe disease or no disease, an ST-T abnormality was not chosen as an independent predictor of 5-year survival; in the group with mild disease, ST-T changes were an independent predictor of reduced survival. Thus, the independent impact of an ST-T abnormality on survival is dependent on the severity of underlying coronary artery disease.",
author = "Crenshaw, {James H.} and Mirvis, {David M.} and Faten El-Zeky and Zwaag, {Roger Vander} and K Ramanathan and Virginia Maddock and Kroetz, {Frank H.} and Sullivan, {Jay M.}",
year = "1991",
month = "1",
day = "1",
doi = "10.1016/0735-1097(91)90594-Y",
language = "English (US)",
volume = "18",
pages = "413--420",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Interactive effects of ST-T wave abnormalities on survival of patients with coronary artery disease

AU - Crenshaw, James H.

AU - Mirvis, David M.

AU - El-Zeky, Faten

AU - Zwaag, Roger Vander

AU - Ramanathan, K

AU - Maddock, Virginia

AU - Kroetz, Frank H.

AU - Sullivan, Jay M.

PY - 1991/1/1

Y1 - 1991/1/1

N2 - Previous studies have documented a reduced survival time in patients with an electrocardiographic (ECG) ST-T wave abnormality. This study was designed to determine the clinical, hemodynamic and angiographic correlates of this observation. Data from 9,731 patients undergoing cardiac catheterization from 1976 through 1986 were analyzed; 5,531 had severe (>70%) obstruction of at least one major coronary artery, 1,706 had mild (10 to 69%) obstruction and 2,494 had no obstruction. Of the patients with severe obstruction, 2,536 were treated medically and 2,995 were treated by surgical revascularization. Patients with an ST-T abnormality had more clinical risk factors (including older age and greater prevalence of diabetes mellitus, hypertension and prior myocardial infarction) and greater left ventricular dysfunction (including higher end-diastolic pressure and ventricular volume, reduced ejection fraction and greater prevalence of contraction abnormality) than did those without this ECG pattern. Survival time was significantly (p < 0.01) reduced in subsets of patients with an ST-T abnormality and with severe or mild coronary artery disease; in those without coronary disease, ST-T changes did not correlate with reduced survival. Stepwise regression analysis was applied to each group to determine the independent predictors of 5-year survival. In patients with severe disease or no disease, an ST-T abnormality was not chosen as an independent predictor of 5-year survival; in the group with mild disease, ST-T changes were an independent predictor of reduced survival. Thus, the independent impact of an ST-T abnormality on survival is dependent on the severity of underlying coronary artery disease.

AB - Previous studies have documented a reduced survival time in patients with an electrocardiographic (ECG) ST-T wave abnormality. This study was designed to determine the clinical, hemodynamic and angiographic correlates of this observation. Data from 9,731 patients undergoing cardiac catheterization from 1976 through 1986 were analyzed; 5,531 had severe (>70%) obstruction of at least one major coronary artery, 1,706 had mild (10 to 69%) obstruction and 2,494 had no obstruction. Of the patients with severe obstruction, 2,536 were treated medically and 2,995 were treated by surgical revascularization. Patients with an ST-T abnormality had more clinical risk factors (including older age and greater prevalence of diabetes mellitus, hypertension and prior myocardial infarction) and greater left ventricular dysfunction (including higher end-diastolic pressure and ventricular volume, reduced ejection fraction and greater prevalence of contraction abnormality) than did those without this ECG pattern. Survival time was significantly (p < 0.01) reduced in subsets of patients with an ST-T abnormality and with severe or mild coronary artery disease; in those without coronary disease, ST-T changes did not correlate with reduced survival. Stepwise regression analysis was applied to each group to determine the independent predictors of 5-year survival. In patients with severe disease or no disease, an ST-T abnormality was not chosen as an independent predictor of 5-year survival; in the group with mild disease, ST-T changes were an independent predictor of reduced survival. Thus, the independent impact of an ST-T abnormality on survival is dependent on the severity of underlying coronary artery disease.

UR - http://www.scopus.com/inward/record.url?scp=0025772331&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025772331&partnerID=8YFLogxK

U2 - 10.1016/0735-1097(91)90594-Y

DO - 10.1016/0735-1097(91)90594-Y

M3 - Article

VL - 18

SP - 413

EP - 420

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 2

ER -