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 journalArticle

4 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 Jan 1
Externally publishedYes

Fingerprint

Cicatrix
Coronary Artery Disease
Single-Photon Emission-Computed Tomography
Ion Channels
Stroke Volume
Cardiac Arrhythmias
Myocardial Infarction
Confidence Intervals

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Early repolarization and myocardial scar predict poorest prognosis in patients with coronary artery disease. / Lee, Hye Young; Mun, Hee Sun; Wi, Jin; Uhm, Jae Sun; Shim, Jaemin; Kim, Jong Youn; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.

In: Yonsei Medical Journal, Vol. 55, No. 4, 01.01.2014, p. 928-936.

Research output: Contribution to journalArticle

Lee, Hye Young ; Mun, Hee Sun ; Wi, Jin ; Uhm, Jae Sun ; Shim, Jaemin ; Kim, Jong Youn ; Pak, Hui Nam ; Lee, Moon Hyoung ; Joung, Boyoung. / Early repolarization and myocardial scar predict poorest prognosis in patients with coronary artery disease. In: Yonsei Medical Journal. 2014 ; Vol. 55, No. 4. pp. 928-936.
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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.",
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AU - Mun, Hee Sun

AU - Wi, Jin

AU - Uhm, Jae Sun

AU - Shim, Jaemin

AU - Kim, Jong Youn

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

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N2 - 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.

AB - 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.

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KW - Sudden cardiac death

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