Abstract 12714: Early Repolarization With J-Point Elevation Predicts Mortality in the Hispanic Female Population
Introduction: Early repolarization (ER) is associated with an increased risk of sudden cardiac death (SCD). However, the impact of ER may not be uniform across race and gender. An analysis from the Biracial Atherosclerosis Risk in Communities Study showed that ER was associated with SCD risk in Caucasians and highest in female Caucasians, while a study from Northern California found no association between cardiovascular mortality and ER in African Americans. Although Hispanics are the second largest segment of the population, little is known about the prevalence or prognostic implications of ER in this group. We investigated possible associations between automated ECG ER readings, defined as J-point elevation with ST segment elevation and overall mortality.
Methods: ECG and EMR databases from a regional medical center from a largely Hispanic population were interrogated. Inclusion criteria included Hispanic ethnicity, age over 18 from 2000-2011. Outcomes were assessed using a Cox Proportional Hazards model with data from the Social Security Death Index.
Results: There were n=34,354 Hispanics of which n=544 (1.6%) had ER. When controlling for age, gender, height/weight, systolic/diastolic BP, PR, QRS, QTc, heart rate, ejection fraction, CAD, CHF, myocardial infarction, DM, and malignancy there was no significant difference in mortality between overall subjects with and without ER (HR: 1.15, 95% CI: 0.89-1.50, p=0.294). However, significant interactions were present between gender and ER. In a multivariate regression model, ER was significantly predictive of overall mortality in females (HR: 1.91, 95% CI: 1.24-2.90, p=0.003), but not in males (HR: 0.88, 95% CI: 0.63-1.23, p=0.456) (Figure 1).
Conclusions: ER is not associated with an increased risk of death in the overall Hispanic population; however, there is a higher risk of overall mortality in female population. ER may be more complex than initially suspected, which emphasizes a need for additional research.
Author Disclosures: E. Shulman: None. P. Aagaard: None. F. Kargoli: None. S. Lener: None. J. Fisher: None. J. Gross: None. S. Kim: None. E. Palma: None. L. DiBiase: None. K. Ferrick: None. A. Krumerman: None.
- © 2014 by American Heart Association, Inc.