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Association of early repolarization pattern with cardiovascular outcomes in middle-aged population: A cohort study.

TitleAssociation of early repolarization pattern with cardiovascular outcomes in middle-aged population: A cohort study.
Publication TypeJournal Article
Year of Publication2020
AuthorsCheng Y-J, Zhao X-X, Pan S-P, Pan J-M, Zhang M, Li Z-Y
JournalClin Cardiol
Date Published2020 Dec
KeywordsAge Factors, Arrhythmias, Cardiac, China, Consensus, Death, Sudden, Cardiac, Electrocardiography, Female, Humans, Male, Middle Aged, Population Surveillance, Prospective Studies, Risk Assessment, Risk Factors, Survival Rate

BACKGROUND: Large cohort studies provide conflicting evidence regarding the prognostic value of early repolarization pattern (ERP) in the general population, complicated by the complex or heterogeneous definitions of ERP applied in different studies.

HYPOTHESIS: We hypothesized that ERP was associated with increased cardiovascular risk with the definition of ERP recommended by the expert consensus statements.

METHODS: A total of 13673 middle-aged subjects from the prospective, population-based Atherosclerosis Risk in Communities (ARIC) study were included in this analysis. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. ERP was defined as ST-segment elevation ≥0.1mV at the end of the QRS or J wave on the QRS downstroke in two or more contiguous leads.

RESULTS: Compared with those without ERP, subjects with ERP had a significantly increased risk of developing sudden cardiac death (SCD) (HR, 1.48; 95% CI, 1.08-2.04) and death from coronary heart disease (CHD) (HR, 1.45; 95% CI, 1.10-1.92) after a median follow-up of 20.1 years. ERP was significantly predictive of SCD in females, whites, younger people, and subjects with relatively low cardiovascular risk. ERP with ST-segment elevation appeared to indicate poor cardiovascular outcomes. ERP was associated with an absolute risk increase of 93.3 additional SCDs per 100 000 person-years.

CONCLUSIONS: Our findings suggest that ERP was an independent predictor of SCD and CHD death in the middle-aged biracial population.

Alternate JournalClin Cardiol
PubMed ID33103793
PubMed Central IDPMC7724230
Grant List81600260 / / National Natural Science Foundation of China /
2016A030313210 / / Guangdong Natural Science Foundation /
2017A020215174 / / Guangdong Province Science and Technology Plan /
201607 / / Medical and Health Project of Huangpu District /
Y50186 / / Kelin New Star of the First Affiliated Hospital of Sun Yat-Sen University /
18ykpy08 / / The Fundamental Research Funds for the Central Universities in Sun Yat-Sen University /