Abstract 14256: The Prevalence and Prognosis of Early Repolarization and Brugada Electrocardiogram Pattern in Patients With Cardiovascular Risk Factors:Japan Morning Surge Home Blood Pressure (J-HOP) Study
Introduction: Patients at high risk for early repolarization (ER) and Brugada electrocardiogram patterns are also at high risk for sudden cardiac death. However, the prevalence and prognosis of ER and Brugada electrocardiogram (ECG) patterns in patients without ventricular fibrillation and with cardiovascular risk factors remains unclear.
Hypothesis: We assessed the hypothesis that ER and Brugada ECG would be associated with cardiovascular events in Japanese patients with cardiovascular risk factors.
Methods: Subjects were 3,128 patients enrolled in the Japan Morning Surge Home Blood Pressure Study who had one or more cardiovascular risk factors. An ER pattern was defined as J-point elevation of at least 0.1 mV from the baseline in at least 2 inferior or lateral leads. Brugada-type ECG was defined as follows: type 1, coved pattern: initial ST elevation ≥2 mm in V1/2; type 2: saddleback pattern in V1/2. The primary endpoints were death and nonfatal cardiovascular events (myocardial infarction, stroke, hospitalization for heart failure, aortic dissection).
Results: During the mean follow-up period of 48±25 months, there were a total of 171 cardiovascular events. One thousand and sixty-eight patients had ER, 38 patients had type 1 Brugada ECG, and 41 patients had type 2 Brugada ECG. Patients with ER were older (64.9±10.7 vs. 63.7±10.6, p=0.003) and more likely to suffer cardiovascular events than patients without ER (N=2,049) (log rank 4.32, p=0.038). However, the difference of cardiovascular events was not statistically significant after adjusting for age and gender (p=0.11). Patients with type 1 Brugada ECG had a higher percentage of males (79% vs. 45%, p<0.001) than patients without Brugada ECG (N=3,049). During the follow-up period, one nonfatal stroke event (type 1 Brugada ECG, 66-year-old female) and one death event (respiratory failure, type 2 Brugada ECG, 71-year-old male) were observed. The rate of cardiovascular events was similar among patients with type 1, type 2, and no Brugada ECG (log rank 0.57, p=0.45).
Conclusions: Early repolarization was not independently associated with poor prognosis, and Brugada-type ECG was not associated with poor prognosis.
Author Disclosures: S. Arima: None. T. Kabutoya: None. H. Shinohara: None. S. Hoshide: None. K. Kario: Research Grant; Significant; Teijin Pharma Limited, OMRON HEALTHCARE Co., Ltd., FUKUDA DENSHI, Bayer Yakuhin Ltd., A &D Co., Ltd., DAIICHI SANKYO COMPANY, LIMITED., MOCHIDA PHARMACEUTICAL CO., LTD, EA pharma, Otsuka Pharmaceutical Co., Ltd., Boehringer Ingelheim Japan Inc., Mitsubishi Tanabe Pharma Corporation., Medtronic Japan Co., Ltd.. Honoraria; Modest; Mitsubishi Tanabe Pharma Corporation., Kyowa Hakko Kirin Co., Ltd., Bayer Yakuhin Ltd., Pfizer Japan Inc., Shionogi & Co., Ltd., Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim Japan Inc., Sanofi K.K., TERUMO CORPORATION, Bristol-Myers K.K., Kowa Pharmaceutical Co. Ltd., SANWA KAGAKU KENKYUSHO CO.,LTD., MSD K.K., Actelion Pharmaceuticals Japan, Abott Japan, OMRON HEALTHCARE Co., Ltd., Century Medical Inc., TOA EIYO LTD., MOCHIDA PHARMACEUTICAL CO., LTD, Sumitomo Dainippon Pharma Co., Ltd.. Honoraria; Significant; Takeda Pharmaceutical Company Limited., DAIICHI SANKYO COMPANY, LIMITED., OMRON HEALTHCARE Co., Ltd..
- © 2016 by American Heart Association, Inc.