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Early repolarization pattern predicts cardiac death and fatal arrhythmia in patients with vasospastic angina.
MedLine Citation:
PMID:  22483625     Owner:  NLM     Status:  Publisher    
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±7.9years), and the prognostic modulation of ER-associated risk by ST-segment variations. RESULTS: Any type of ER≥0.1mV 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±4.7years, 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≥0.1mV 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.
Chang-Myung Oh; Jaewon Oh; Dong-Ho Shin; Hye-Jin Hwang; Byeong-Keuk Kim; Hui-Nam Pak; Moon-Hyoung Lee; Boyoung Joung
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-6
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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