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(Stroke. 2003;34:e250.)
© 2003 American Heart Association, Inc.

Research Reports

Prospective Study of Major and Minor ST-T Abnormalities and Risk of Stroke Among Japanese

Tetsuya Ohira, MD; Hiroyasu Iso, MD; Hironori Imano, MD; Akihiko Kitamura, MD; Shinichi Sato, MD; Yuko Nakagawa, MD; Yoshihiko Naito, MD; Tomoko Sankai, MD; Takeshi Tanigawa, MD; Kazumasa Yamagishi, MD; Minoru Iida, MD Takashi Shimamoto, MD

From Osaka Medical Center for Health Science and Promotion (T.O., H. Imano, A.K., S.S., Y. Nakagawa, Y. Naito, M.I., T. Shimamoto), Osaka; Department of Public Health Medicine (H. Iso, T.T., K.Y.), Institute of Community Medicine, University of Tsukuba, Tsukuba-shi, Ibaraki; and Toride Plant (T. Sankai), Canon Inc, Toride-shi, Ibaraki, Japan.

Address correspondence and reprint requests to: Tetsuya Ohira, MD, Osaka Medical Center for Health Science and Promotion, 1–3-2 Nakamichi, Higashinari-ku, Osaka, 537-0025 Japan. Telephone +81 6 6973 3535; Fax +81 6 6973 3574; E-mail teoohira-circ{at}umin.ac.jp

Background and Purpose— The association between minor ST-T abnormalities and stroke incidence has not been well elucidated. We sought to examine the relationship between nonspecific minor or major ST-T abnormalities and the incidence of stroke among Japanese men and women.

Methods— A 15.4-year prospective study was conducted with 10 741 men and women aged 40 to 69 years in 4 Japanese communities. Electrocardiograms were taken at baseline and were read according to the Minnesota Code. The incidence of stroke was ascertained using systematic surveillance.

Results— During the 15.4-year follow-up, 602 strokes (339 ischemic strokes, 129 intracerebral hemorrhages, 80 subarachnoid hemorrhages, and 54 unclassified strokes) occurred. Both men and women with major ST-T abnormalities had approximately 3-fold higher age-adjusted relative risk and 2-fold higher multivariate-adjusted relative risk of total stroke than did those without such abnormalities. Men with minor ST-T abnormalities had a 2.3-fold higher age-adjusted relative risk of total stroke, both ischemic and hemorrhagic, than did those without such abnormalities. After we adjusted further for hypertension category, the relative risk for minor ST-T abnormalities was reduced substantially but remained statistically significant: 1.8 (95% CI, 1.3 to 2.4) for total stroke, 1.9 (95%CI, 1.3 to 2.8) for ischemic stroke, and 1.7 (95% CI, 1.0 to 3.0) for hemorrhagic stroke. For women, however, there was no relation between minor ST-T abnormalities and stroke incidence.

Conclusions— Minor ST-T abnormalities have predictive value for the risk of total stroke, both ischemic and hemorrhagic, among middle-aged Japanese men, as do major ST-T abnormalities for both sexes.

Key Words: cohort studies • electrocardiography • risk factors • stroke, hemorrhagic • stroke, ischemic