Early repolarization pattern predicts cardiac death and fatal arrhythmia in patients with vasospastic angina

Chang Myung Oh, Jaewon Oh, Dong Ho Shin, Hye Jin Hwang, Byeong Keuk Kim, huinam pak, Moon Hyoung Lee, Boyoung Joung

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Early repolarization (ER), which is characterized by an elevation of J-point, is sometimes associated with fatal arrhythmia and sudden cardiac death in patients without structural heart disease. This study investigated the prevalence and prognostic significance of ER in patients with vasospastic angina (VA). Methods: We assessed the ER pattern in 281 VA patients (mean age, 50.5 ± 7.9 years), and the prognostic modulation of ER-associated risk by ST-segment variations. Results: Any type of ER ≥ 0.1 mV in inferior and/or lateral leads was persistently observed after chest pain in 60 (21.4%) VA patients. During the follow up period of 7.6 ± 4.7 years, patients with ER had higher incidence of cardiac events including cardiac death, aborted sudden cardiac death or fatal arrhythmia than those with no ER (20.0% vs 5.4%, p = 0.001). Patients with ER ≥ 0.1 mV and horizontal/descending ST variant (n = 18) had an increased age- and sex-adjusted hazard ratio of cardiac events (relative risk 8.12; 95% confidence interval 3.45-19.12). When modeled for ER in inferior leads and horizontal/descending ST-segment variant, the hazard ratio of cardiac events increased to 8.89 (95% confidence interval 3.78-20.91). However, in subjects with ascending ST variant, the relative risk for arrhythmic death was not significantly increased. Conclusion: ER was observed in a fifth of VA patients, and was associated with an increased risk of cardiac events in VA. However, it is also possible that, in patients with ER, VA might cause an adverse event or facilitate the diagnosis of ER.

Original languageEnglish
Pages (from-to)1181-1187
Number of pages7
JournalInternational Journal of Cardiology
Volume167
Issue number4
DOIs
Publication statusPublished - 2013 Aug 20

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Cardiac Arrhythmias
Sudden Cardiac Death
Confidence Intervals
Chest Pain
Heart Diseases
Cross-Sectional Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Oh, Chang Myung ; Oh, Jaewon ; Shin, Dong Ho ; Hwang, Hye Jin ; Kim, Byeong Keuk ; pak, huinam ; Lee, Moon Hyoung ; Joung, Boyoung. / Early repolarization pattern predicts cardiac death and fatal arrhythmia in patients with vasospastic angina. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 4. pp. 1181-1187.
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abstract = "Background: Early repolarization (ER), which is characterized by an elevation of J-point, is sometimes associated with fatal arrhythmia and sudden cardiac death in patients without structural heart disease. This study investigated the prevalence and prognostic significance of ER in patients with vasospastic angina (VA). Methods: We assessed the ER pattern in 281 VA patients (mean age, 50.5 ± 7.9 years), and the prognostic modulation of ER-associated risk by ST-segment variations. Results: Any type of ER ≥ 0.1 mV in inferior and/or lateral leads was persistently observed after chest pain in 60 (21.4{\%}) VA patients. During the follow up period of 7.6 ± 4.7 years, patients with ER had higher incidence of cardiac events including cardiac death, aborted sudden cardiac death or fatal arrhythmia than those with no ER (20.0{\%} vs 5.4{\%}, p = 0.001). Patients with ER ≥ 0.1 mV and horizontal/descending ST variant (n = 18) had an increased age- and sex-adjusted hazard ratio of cardiac events (relative risk 8.12; 95{\%} confidence interval 3.45-19.12). When modeled for ER in inferior leads and horizontal/descending ST-segment variant, the hazard ratio of cardiac events increased to 8.89 (95{\%} confidence interval 3.78-20.91). However, in subjects with ascending ST variant, the relative risk for arrhythmic death was not significantly increased. Conclusion: ER was observed in a fifth of VA patients, and was associated with an increased risk of cardiac events in VA. However, it is also possible that, in patients with ER, VA might cause an adverse event or facilitate the diagnosis of ER.",
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Early repolarization pattern predicts cardiac death and fatal arrhythmia in patients with vasospastic angina. / Oh, Chang Myung; Oh, Jaewon; Shin, Dong Ho; Hwang, Hye Jin; Kim, Byeong Keuk; pak, huinam; Lee, Moon Hyoung; Joung, Boyoung.

In: International Journal of Cardiology, Vol. 167, No. 4, 20.08.2013, p. 1181-1187.

Research output: Contribution to journalArticle

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AU - Oh, Chang Myung

AU - Oh, Jaewon

AU - Shin, Dong Ho

AU - Hwang, Hye Jin

AU - Kim, Byeong Keuk

AU - pak, huinam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

PY - 2013/8/20

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N2 - Background: Early repolarization (ER), which is characterized by an elevation of J-point, is sometimes associated with fatal arrhythmia and sudden cardiac death in patients without structural heart disease. This study investigated the prevalence and prognostic significance of ER in patients with vasospastic angina (VA). Methods: We assessed the ER pattern in 281 VA patients (mean age, 50.5 ± 7.9 years), and the prognostic modulation of ER-associated risk by ST-segment variations. Results: Any type of ER ≥ 0.1 mV in inferior and/or lateral leads was persistently observed after chest pain in 60 (21.4%) VA patients. During the follow up period of 7.6 ± 4.7 years, patients with ER had higher incidence of cardiac events including cardiac death, aborted sudden cardiac death or fatal arrhythmia than those with no ER (20.0% vs 5.4%, p = 0.001). Patients with ER ≥ 0.1 mV and horizontal/descending ST variant (n = 18) had an increased age- and sex-adjusted hazard ratio of cardiac events (relative risk 8.12; 95% confidence interval 3.45-19.12). When modeled for ER in inferior leads and horizontal/descending ST-segment variant, the hazard ratio of cardiac events increased to 8.89 (95% confidence interval 3.78-20.91). However, in subjects with ascending ST variant, the relative risk for arrhythmic death was not significantly increased. Conclusion: ER was observed in a fifth of VA patients, and was associated with an increased risk of cardiac events in VA. However, it is also possible that, in patients with ER, VA might cause an adverse event or facilitate the diagnosis of ER.

AB - Background: Early repolarization (ER), which is characterized by an elevation of J-point, is sometimes associated with fatal arrhythmia and sudden cardiac death in patients without structural heart disease. This study investigated the prevalence and prognostic significance of ER in patients with vasospastic angina (VA). Methods: We assessed the ER pattern in 281 VA patients (mean age, 50.5 ± 7.9 years), and the prognostic modulation of ER-associated risk by ST-segment variations. Results: Any type of ER ≥ 0.1 mV in inferior and/or lateral leads was persistently observed after chest pain in 60 (21.4%) VA patients. During the follow up period of 7.6 ± 4.7 years, patients with ER had higher incidence of cardiac events including cardiac death, aborted sudden cardiac death or fatal arrhythmia than those with no ER (20.0% vs 5.4%, p = 0.001). Patients with ER ≥ 0.1 mV and horizontal/descending ST variant (n = 18) had an increased age- and sex-adjusted hazard ratio of cardiac events (relative risk 8.12; 95% confidence interval 3.45-19.12). When modeled for ER in inferior leads and horizontal/descending ST-segment variant, the hazard ratio of cardiac events increased to 8.89 (95% confidence interval 3.78-20.91). However, in subjects with ascending ST variant, the relative risk for arrhythmic death was not significantly increased. Conclusion: ER was observed in a fifth of VA patients, and was associated with an increased risk of cardiac events in VA. However, it is also possible that, in patients with ER, VA might cause an adverse event or facilitate the diagnosis of ER.

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