Long-term prognosis associated with early repolarisation pattern in Chinese population with atherosclerotic risk factors
Long-term prognosis associated with early repolarisation pattern in Chinese population with atherosclerotic risk factors
复制标题
具有动脉粥样硬化危险因素的中国人群的长期预后与早期复极模式相关
DOI：
10.1136/heartjnl-2016-310259
复制
发表时间：
2017
期刊：
影响因子：
5.7
通讯作者：
Wu Su Hua
中科院分区：
文献类型：
--
作者：
Cheng Yun Jiu;Mei Wei Yi;Chen Xu Miao;Liu Li Juan;Zheng Dong Dan;Ji Cheng cheng;Tang Kai;Wu Su Hua
背景最近的证据表明，早期复极模式（ERP）与无器质性心脏病患者的心源性猝死（SCD）有关。然而，没有研究已经澄清了ERP的预后价值在高风险的人动脉粥样硬化heartdisease.MethodsWe前瞻性评估的预后意义ERP的心电图在社区为基础的人口18 231例动脉粥样硬化的危险因素（49.3%的男性，平均年龄64.0岁）。 平均随访7.6年。 考克斯模型用于估计调整可能的混杂因素后的危险比（HR）。结果与无ERP的受试者相比，ERP的受试者发生SCD的风险显著增加（HR 1.91，95% CI 1.30 - 2.82），死于冠心病（CHD）（HR 1.80，95% CI 1.45 - 2.22）和全因死亡（HR 1.35，95% CI 1.22 - 1.50）。ERP与非冠心病猝死和非冠心病死亡的风险增加无关。下壁导联J波型、J波高幅、切迹、ST段水平或下降者发生SCD的危险性较高。ERP是与一个绝对的风险增加52.3额外的SCD每100 000人-年的人群中动脉粥样硬化性心脏病的高风险为atherosclerosis heart disease.ConclusionsERP是与SCD，冠心病死亡和死亡的任何原因的人动脉粥样硬化的危险因素的风险显着增加。 观察到的ERP和全因死亡率之间的相关性似乎是由与CHD死亡，特别是SCD的相关性驱动的。
BackgroundRecent evidence has linked early repolarisation pattern (ERP) to sudden cardiac death (SCD) in patients without structural heart disease. However, no studies have clarified the prognostic value of ERP in people at high risk for atherosclerotic heart disease.MethodsWe prospectively assessed the prognostic significance of ERP on ECGs in a community-based population of 18 231 subjects with atherosclerotic risk factors (49.3% men, mean age 64.0 years). Mean follow-up was 7.6 years. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors.ResultsCompared with those without ERP, subjects with ERP had a significantly increased risk of developing SCD (HR 1.91, 95% CI 1.30 to 2.82), death from coronary heart disease (CHD) (HR 1.80, 95% CI 1.45 to 2.22) and death from any cause (HR 1.35, 95% CI 1.22 to 1.50). ERP was not associated with an increased risk of non-sudden CHD death and non-CHD death. ERP with J wave pattern in inferior leads, high amplitude of J wave pattern, notching configuration and horizontal or descending ST segment indicated a higher risk for SCD. ERP was associated with an absolute risk increase of 52.3 additional SCDs per 100 000 person-years in the population at high risk for atherosclerotic heart disease.ConclusionsERP is associated with a significantly increased risk for SCD, CHD death and death from any cause in people with atherosclerotic risk factors. The observed association between ERP and all-cause mortality appears to be driven by an association with CHD death, in particular SCD.