Early repolarization and myocardial scar predict poorest prognosis in patients with coronary artery disease

Hye Young Lee, Hee Sun Mun, Jin Wi, Jae Sun Uhm, Jaemin Shim, Jong Youn Kim, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung

    Research output: Contribution to journalArticlepeer-review

    5 Citations (Scopus)

    Abstract

    Purpose: Recent studies show positive association of early repolarization (ER) with the risk of life-threatening arrhythmias in patients with coronary artery disease (CAD). This study was to investigate the relationships of ER with myocardial scarring and prognosis in patients with CAD. Materials and Methods: Of 570 consecutive CAD patients, patients with and without ER were assigned to ER group (n=139) and no ER group (n=431), respectively. Myocardial scar was evaluated using cardiac single-photon emission computed tomography. Results: ER group had previous history of myocardial infarction (33% vs. 15%, p<0.001) and lower left ventricular ejection fraction (57±13% vs. 62±13%, p<0.001) more frequently than no-ER group. While 74 (53%) patients in ER group had myocardial scar, only 121 (28%) patients had in no-ER group (p<0.001). During follow up, 9 (7%) and 4 (0.9%) patients had cardiac events in ER and no-ER group, respectively (p=0.001). All patients with cardiac events had ER in inferior leads and horizontal/descending ST-segment. Patients with both ER in inferior leads and horizontal/descending ST variant and scar had an increased adjusted hazard ratio of cardiac events (hazard ratio 16.0; 95% confidence interval: 4.1 to 55.8; p<0.001). Conclusion: ER in inferior leads with a horizontal/descending ST variant was associated with increased risk of cardiac events. These findings suggest that ER in patients with CAD may be related to myocardial scar rather than pure ion channel problem.

    Original languageEnglish
    Pages (from-to)928-936
    Number of pages9
    JournalYonsei medical journal
    Volume55
    Issue number4
    DOIs
    Publication statusPublished - 2014 Jul

    Keywords

    • Cardiac arrhythmia
    • Coronary artery disease
    • Electrocardiography
    • Sudden cardiac death

    ASJC Scopus subject areas

    • Medicine(all)

    Fingerprint

    Dive into the research topics of 'Early repolarization and myocardial scar predict poorest prognosis in patients with coronary artery disease'. Together they form a unique fingerprint.

    Cite this