Beckerman et al evaluated ST segment and T wave abnormalities in the resting electrocardiogram as they relate to risk of cardiovascular mortality. These can help to identify patients who may benefit from more aggressive management. The authors are from Stanford University and the Veterans Affairs Palo Alto Health Care System.
(1) T wave abnormalities (minor = 5-3 or 5-4; major = 5-1 or 5-2)
(2) ST segment depression (minor = 4-3; major = 4-1 or 4-2).
T Wave Abnormality
ST Segment Depression
Relative Risk
none
none
1
minor
nonsignificant
major
nonsignificant
minor
none
1.9
minor
1.8
major
2.0
major
none
nonsignificant
minor
3.2
major
3.3
where:
• The risk if there was a minor T-wave abnormality is around 2.
The conclusions are that both ST segment depression and T-wave abnormalities are independent predictors of cardiovascular death, with T-wave abnormalities being more significant.
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