Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .
Impact of minor electrocardiographic ST-segment and/or T-wave abnormalities on cardiovascular mortality during long-term follow-up.
Minor ST-T abnormalities are common on the resting electrocardiogram of otherwise healthy persons , but the long-term importance of these findings has not been extensively evaluated , especially in women . In a prospect i ve study , 7,985 women and 9,630 men ( aged 40 to 64 years at baseline ) without other electrocardiographic abnormalities and free of previous coronary heart disease ( CHD ) were studied using Cox regression for 22-years of follow-up . Primary outcomes were death from CHD and total cardiovascular disease ( CVD ) ; total mortality was a secondary outcome . Minnesota Code was employed to assess the presence or absence of  electrocardiographic abnormalities . Analyses compared persons with  minor Minnesota Code ST-segment ( codes 4 - 3 or 4 - 4 ) or  T-wave findings  ( codes 5 - 3 or 5 - 4 ) to those with normal electrocardiographic findings . In combined analyses of men and women adjusted for age , isolated minor T-wave abnormality , minor ST-segment depression , or a combination of minor ST-segment and T-wave abnormalities were each associated with increased mortality risks . For CHD mortality , hazard ratios ( HRs ) ranged from 1.60 to 2.10 ; for CVD mortality , HRs ranged from 1.50 to 1.95 ; and for total mortality , HRs ranged from 1.31 to 1.50 ( p < 0.05 for all HRs ) . In separate analyses by gender adjusted for age , increased risks were observed for combined ST-T-wave abnormalities in both genders for CHD and CVD mortality ( HR 1.72 to 1.75 for men , p < 0.05 ; HR 2.07 to 2.51 for women , p < 0.001 ) . These data indicate that nonspecific ( minor ) ST-segment depression and /or T-wave abnormalities have a long-term prognostic impact for CHD and CVD death in middle-aged women and men and can be considered markers of heightened CHD and CVD risk
Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .