Open AccessLong‐Term Prognosis of Brugada‐Type ECG and ECG With Atypical ST ‐Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study ( CIRCS )
Author(s) -
Tsuneoka Hidekazu,
Takagi Masahiko,
Murakoshi Nobuyuki,
Yamagishi Kazumasa,
Yokoyama Yasuhiro,
Xu DongZhu,
Sekiguchi Yukio,
Yamasaki Hiro,
Naruse Yoshihisa,
Ito Yoko,
Igarashi Miyako,
Kitamura Akihiko,
Okada Takeo,
Tanigawa Takeshi,
Kuga Keisuke,
Ohira Tetsuya,
Tada Hiroshi,
Aonuma Kazutaka,
Iso Hiroyasu
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.002899
Subject(s) - medicine , brugada syndrome , cardiology , hazard ratio , sudden cardiac death , precordial examination , st elevation , benign early repolarization , st segment , sudden death , electrocardiography , confidence interval , myocardial infarction
Background Brugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non–type 1 Brugada‐type ECG (BrS) or atypical ST ‐segment elevation in the right precordial leads ( STERP ) and the long‐term prognosis for those patients remain unknown. Methods and Results We analyzed standard 12‐lead ECG s of 7178 apparently healthy participants (age range 40–64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community‐based cohort study in Japan. ECG s with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non‐type 1 BrS), and (3) STERP . The others served as the non– ST ‐segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non–type 1 BrS, and 228 (3.2%) with STERP . During a median follow‐up of 18.7 years (133 987.0 person‐years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non–type 1 BrS, in 7 (3.1%) with STERP , and in 50 (0.7%) with non– ST ‐segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7–9.0). Conclusions STERP was associated with an elevated risk of sudden cardiac death in a middle‐aged population.