Characteristics of early repolarization parameters and prognostic implications in the general ambulatory Korean population

Int J Cardiol. 2017 Jan 15:227:571-576. doi: 10.1016/j.ijcard.2016.10.099. Epub 2016 Nov 1.

Abstract

Background: We tested a hypothesis that the 2 fundamental components of early repolarization (ER), J wave and ST elevation (STE) might have different prevalence and prognostic implications.

Methods: The study population comprised 26,345 general ambulatory Korean subjects (mean 48.0±10.2years old, 53.2% male) who underwent medical checkups from January 2002 to December 2002. ER was found in 2950 subjects (11.2%), who were divided into 3 groups (J [J wave only, n=1874, 7.1%], JST [both J wave and STE, n=489, 1.8%], and ST [STE only, n=587, 2.3%]).

Results: The prevalence of STE decreased with age, whereas J waves remained at a constant level in all age groups. The most common pattern of ER was the J pattern, with a horizontal/descending ST segment in the inferior leads; in lateral precordial leads, ST or JST patterns with ascending ST segments were more common. During the mean follow-up of 126.0±11.1months, a total of 710 subjects died (2.7%). Subjects in the J group were at higher risk (Hazard ratio 1.60, 95% confidence interval 1.27-2.01, p<0.001), while those in the JST and ST groups showed similar survival outcomes compared to controls without J waves or STE.

Conclusions: J waves and STE showed different age and lead distributions and prognostic implications. The presence of the J wave itself was associated with a higher relative risk of mortality. However, due to the low event rate, its clinical significance appears to be limited.

Keywords: Age distribution; Early repolarization; Electrocardiography; J wave; Mortality; Outcome.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / methods
  • Analysis of Variance
  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / mortality
  • Arrhythmias, Cardiac / therapy*
  • Cause of Death
  • Cohort Studies
  • Confidence Intervals
  • Death, Sudden, Cardiac / prevention & control*
  • Electrocardiography*
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Conduction System / physiopathology*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Survival Rate
  • Time Factors
  • Treatment Outcome