Early repolarization pattern in an ethnically diverse population: Increased risk in Hispanics

Background Early repolarization (ER) pattern on ECG is associated with an increased mortality in Caucasians. This study analyzed the association between ER pattern and all‐cause mortality in a population of multiple ethnicities. Methods A total of 20 000 individuals were randomly selected and their ECGs were analyzed for ER pattern using the 2015 consensus: end‐QRS notching or slurring with a J‐point ( Jp ) ≥0.1 mV in contiguous inferior or lateral leads. Exclusion criteria were age <18, QRS duration of ≥120 ms, and acute myocardial infarction. Kaplan‐Meier survival curves were used to assess crude survival, and multivariable logistic regression models were used to determine predictors of all‐cause mortality. Results A total of 17 901 patients with a mean age of 53 met inclusion criteria. Individuals were 62% female, 14% White, 37% Black, 40% Hispanic, and 9% other. Median follow‐up time was 6.4 years. ER pattern was noted in 995 (5.6%) patients. Jp ≥2 mm was noted in 282 (1.6%) patients. In those with ER pattern and Jp  ≥1 mm, there was no difference in mortality when compared to individuals without Jp elevation (odds ratio [OR]: 0.962, 95% confidence of interval [CI]: 0.819‐1.131). Patients with Jp ≥2 mm had a significantly increased all‐cause mortality (OR: 1.333, 95% CI: 1.009‐1.742). This increased mortality was also significant in Hispanic patients with Jp ≥2 mm (OR: 1.584, 95% CI: 1.003‐2.502). Conclusion ER pattern with Jp ≥2 mm is associated with increased mortality in a multiethnic population, apparently driven by an increased risk in Hispanics.