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Early repolarization pattern in an ethnically diverse population: Increased risk in Hispanics
Author(s) -
Leiderman Ephraim,
Kargoli Faraj,
Shulman Eric,
Aagaard Philip,
Hoch Ethan,
Zaremski Lynn,
Di Biase Luigi,
Kim Soo G.,
Gross Jay N.,
Ferrick Kevin J.,
Fisher John,
Krumerman Andrew
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13827
Subject(s) - medicine , benign early repolarization , confidence interval , odds ratio , qrs complex , myocardial infarction , cardiology , logistic regression , population , st segment , environmental health
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.