Long-term prognosis associated with J-point elevation in a large middle-aged biracial cohort: the ARIC study
Long-term prognosis associated with J-point elevation in a large middle-aged biracial cohort: the ARIC study
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DOI：
10.1093/eurheartj/ehr264
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发表时间：
2011-12-01
影响因子：
39.3
通讯作者：
Rosamond, Wayne D.
中科院分区：
文献类型：
--
作者：
Olson, Kristoff A.;Viera, Anthony J.;Rosamond, Wayne D.
目的心律失常死亡与早期复极之间存在关联，早期复极是一种以QRS-ST连接点（j点）升高为特征的心电图模式。在非白人人群中，这种关系知之甚少。本研究探讨了j点升高（JPE）与心源性猝死（SCD）之间的关系，以及这种关系是否因种族或性别而异。方法和结果来自前瞻性、基于人群的社区动脉粥样硬化风险（ARIC）研究的15141名中年受试者纳入本分析。主要终点是从基线（1987-1989）到2002年12月发生的医生判定的SCD，次要终点是到2007年12月发生的致死性和非致死性冠状动脉事件和全因死亡率。j点高程定义为j点振幅>= 0.1 mV。按性别和种族进行预先指定的亚组分析。1866名受试者（12.3%）出现任何铅的j点升高。在调整了人口统计学、临床、生活方式和实验室变量后，总体样本中JPE与SCD没有显著相关性[校正风险比（HR）， 1.23；95%可信区间（CI）， 0.87-1.75]。然而，种族与JPE之间存在显著的相互作用（P = 0.006），性别与JPE之间存在显著的相互作用（P = 0.020）。j点升高可显著预测白人（校正HR， 2.03; 95% CI, 1.28-3.21）和女性（校正HR， 2.54; 95% CI, 1.34-4.82）的SCD。结论：我们的研究结果表明，JPE与白人和女性SCD风险增加有关，但与黑人和男性无关。需要进一步的研究来澄清哪些JPE患者亚组发生不良心脏事件的风险增加。
Aims An association has been described between death from arrhythmia and early repolarization, an electrocardiogram pattern characterized by elevation of the QRS-ST junction (J-point). Little is known about this relationship in non-white populations. This study examines the relationship between J-point elevation (JPE) and sudden cardiac death (SCD) and whether this relationship differs by race or sex.Methods and results A total of 15 141 middle-aged subjects from the prospective, population-based Atherosclerosis Risk in Communities (ARIC) study were included in this analysis. The primary endpoint was physician-adjudicated SCD occurring from baseline (1987-1989) through December 2002, secondary endpoints were fatal and non-fatal coronary events and all-cause mortality occurring through December 2007. J-point elevation was defined as J-point amplitude >= 0.1 mV. Pre-specified subgroup analyses by sex and race were conducted. J-point elevation in any lead was present in 1866 subjects (12.3%). After adjustment for demographic, clinical, lifestyle, and laboratory variables, JPE was not significantly related to SCD in the overall sample [adjusted hazard ratio (HR), 1.23; 95% confidence interval (CI), 0.87-1.75]. However, significant interactions were present between race and JPE (P = 0.006) and between sex and JPE (P = 0.020). J-point elevation was significantly predictive of SCD in whites (adjusted HR, 2.03; 95% CI, 1.28-3.21) and in females (adjusted HR, 2.54; 95% CI, 1.34-4.82).Conclusion Our results suggest that JPE is associated with an increased risk of SCD in whites and in females, but not in blacks or males. Further studies are needed to clarify which subgroups of individuals with JPE are at increased risk for adverse cardiac events.