#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Association of Early Repolarization Pattern on ECG with Risk of Cardiac and All-Cause Mortality: A Population-Based Prospective Cohort Study (MONICA/KORA)


Background:
Early repolarization pattern (ERP) on electrocardiogram was associated with idiopathic ventricular fibrillation and sudden cardiac arrest in a case-control study and with cardiovascular mortality in a Finnish community-based sample. We sought to determine ERP prevalence and its association with cardiac and all-cause mortality in a large, prospective, population-based case-cohort study (Monitoring of Cardiovascular Diseases and Conditions [MONICA]/KORA [Cooperative Health Research in the Region of Augsburg]) comprised of individuals of Central-European descent.

Methods and Findings:
Electrocardiograms of 1,945 participants aged 35–74 y, representing a source population of 6,213 individuals, were analyzed applying a case-cohort design. Mean follow-up was 18.9 y. Cause of death was ascertained by the 9th revision of the International Classification of Disease (ICD-9) codes as documented in death certificates. ERP-attributable effects on mortality were determined by a weighted Cox proportional hazard model adjusted for covariables. Prevalence of ERP was 13.1% in our study. ERP was associated with cardiac and all-cause mortality, most pronounced in those of younger age and male sex; a clear ERP-age interaction was detected (p = 0.005). Age-stratified analyses showed hazard ratios (HRs) for cardiac mortality of 1.96 (95% confidence interval [CI] 1.05–3.68, p = 0.035) for both sexes and 2.65 (95% CI 1.21–5.83, p = 0.015) for men between 35–54 y. An inferior localization of ERP further increased ERP-attributable cardiac mortality to HRs of 3.15 (95% CI 1.58–6.28, p = 0.001) for both sexes and to 4.27 (95% CI 1.90–9.61, p<0.001) for men between 35–54 y. HRs for all-cause mortality were weaker but reached significance.

Conclusions:
We found a high prevalence of ERP in our population-based cohort of middle-aged individuals. ERP was associated with about a 2- to 4-fold increased risk of cardiac mortality in individuals between 35 and 54 y. An inferior localization of ERP was associated with a particularly increased risk.

: Please see later in the article for the Editors' Summary


Vyšlo v časopise: Association of Early Repolarization Pattern on ECG with Risk of Cardiac and All-Cause Mortality: A Population-Based Prospective Cohort Study (MONICA/KORA). PLoS Med 7(7): e32767. doi:10.1371/journal.pmed.1000314
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1000314

Souhrn

Background:
Early repolarization pattern (ERP) on electrocardiogram was associated with idiopathic ventricular fibrillation and sudden cardiac arrest in a case-control study and with cardiovascular mortality in a Finnish community-based sample. We sought to determine ERP prevalence and its association with cardiac and all-cause mortality in a large, prospective, population-based case-cohort study (Monitoring of Cardiovascular Diseases and Conditions [MONICA]/KORA [Cooperative Health Research in the Region of Augsburg]) comprised of individuals of Central-European descent.

Methods and Findings:
Electrocardiograms of 1,945 participants aged 35–74 y, representing a source population of 6,213 individuals, were analyzed applying a case-cohort design. Mean follow-up was 18.9 y. Cause of death was ascertained by the 9th revision of the International Classification of Disease (ICD-9) codes as documented in death certificates. ERP-attributable effects on mortality were determined by a weighted Cox proportional hazard model adjusted for covariables. Prevalence of ERP was 13.1% in our study. ERP was associated with cardiac and all-cause mortality, most pronounced in those of younger age and male sex; a clear ERP-age interaction was detected (p = 0.005). Age-stratified analyses showed hazard ratios (HRs) for cardiac mortality of 1.96 (95% confidence interval [CI] 1.05–3.68, p = 0.035) for both sexes and 2.65 (95% CI 1.21–5.83, p = 0.015) for men between 35–54 y. An inferior localization of ERP further increased ERP-attributable cardiac mortality to HRs of 3.15 (95% CI 1.58–6.28, p = 0.001) for both sexes and to 4.27 (95% CI 1.90–9.61, p<0.001) for men between 35–54 y. HRs for all-cause mortality were weaker but reached significance.

Conclusions:
We found a high prevalence of ERP in our population-based cohort of middle-aged individuals. ERP was associated with about a 2- to 4-fold increased risk of cardiac mortality in individuals between 35 and 54 y. An inferior localization of ERP was associated with a particularly increased risk.

: Please see later in the article for the Editors' Summary


Zdroje

1. WasserburgerRH

AltWJ

1961 The normal RS-T segment elevation variant. Am J Cardiol 8 184 192

2. ShipleyRA

HallaranWR

1936 The four lead electrocardiogram in 200 normal men and women. Am Heart J 11 325 345

3. MehtaM

JainAC

MehtaA

1999 Early repolarization. Clin Cardiol 22 59 65

4. MehtaMC

JainAC

1995 Early repolarization on scalar electrocardiogram. Am J Med Sci 309 305 311

5. KlatskyAL

OehmR

CooperRA

UdaltsovaN

ArmstrongMA

2003 The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med 115 171 177

6. GussakI

AntzelevitchC

2000 Early repolarization syndrome: clinical characteristics and possible cellular and ionic mechanisms. J Electrocardiol 33 299 309

7. HaïssaguerreM

DervalN

SacherF

JeselL

DeisenhoferI

2008 Sudden cardiac arrest associated with early repolarization. N Engl J Med 358 2016 2023

8. TikkanenJT

AnttonenO

JunttilaMJ

AroAL

KerolaT

2009 Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 361 2529 2537

9. HuikuriHV

CastellanosA

MyerburgRJ

2001 Sudden death due to cardiac arrhythmias. N Engl J Med 345 1473 1482

10. ChughSS

ReinierK

TeodorescuC

EvanadoA

KehrE

2008 Epidemiology of sudden cardiac death: clinical and research implications. Prog Cardiovasc Dis 51 213 228

11. Tunstall-PedoeH

1988 The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol 41 105 114

12. HolleR

HappichM

LöwelH

WichmannHE

MONIKA/KORA Study Group 2005 KORA–a research platform for population based health research. Gesundheitswesen 67 Suppl 1 S19 S25

13. BarlowWE

1994 Robust variance estimation for the case-cohort design. Biometrics 50 1064 1072

14. WacholderS

GailM

PeeD

1991 Selecting an efficient design for assessing exposure-disease relationships in an assembled cohort. Biometrics 47 63 76

15. HerderC

IlligT

BaumertJ

MüllerM

KloppN

2008 Macrophage migration inhibitory factor (MIF) and risk for coronary heart disease: results from the MONICA/KORA Augsburg case-cohort study, 1984–2002. Atherosclerosis 200 380 388

16. ThorandB

KolbH

BaumertJ

KoenigW

ChamblessL

2005 Elevated levels of interleukin-18 predict the development of type 2 diabetes: results from the MONICA/KORA Augsburg Study, 1984–2002. Diabetes 54 2932 2938

17. ThorandB

SchneiderA

BaumertJ

DöringA

Marowsky-KöpplM

2005 Case-cohort studies: an effective design for the investigation of biomarkers as risk factors for chronic diseases–demonstrated by the example of the MONICA/KORA Augsburg Case-Cohort Study 1984–2002. Gesundheitswesen 67 Suppl 1 S98 S102

18. CoxDR

1972 Regression models and life-tables. J R Stat Soc Series B Stat Methodol 34 187 220

19. GrambschPM

TherneauTM

1994 Proportional hazards tests and diagnostics based on weighted residuals. Biometrika 81 515 526

20. SagieA

LarsonMG

GoldbergRJ

BengtsonJR

LevyD

1992 An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol 70 797 801

21. VinsonneauU

BrondexA

Vergez-LarrougetC

2009 Prevalence of the early repolarization aspect in a healthy women population. Eur Heart J 30 167

22. BehrER

WoodDA

WrightM

SyrrisP

SheppardMN

2003 Cardiological assessment of first-degree relatives in sudden arrhythmic death syndrome. Lancet 362 1457 1459

23. WistenA

ForsbergH

KrantzP

MessnerT

2002 Sudden cardiac death in 15–35-year olds in Sweden during 1992–99. J Intern Med 252 529 536

24. ChughS

2003 Cardiac pathologic findings reveal a high rate of sudden cardiac death of undetermined etiology in younger women. Am Heart J 146 635 639

25. EckartR

ScovilleS

ShryE

PotterR

TedrowU

2006 Causes of sudden death in young female military recruits. Am J Cardiol 97 1756 1758

26. DekkerLR

BezzinaCR

HenriquesJP

TanckMW

KochKT

2006 Familial sudden death is an important risk factor for primary ventricular fibrillation: a case-control study in acute myocardial infarction patients. Circulation 114 1140 1145

27. PiliaG

ChenWM

ScuteriA

OrrúM

AlbaiG

2006 Heritability of cardiovascular and personality traits in 6,148 Sardinians. PLoS Genet 2 e132 doi:10.1371/journal.pgen.0020132

28. Newton-ChehC

LarsonMG

CoreyDC

BenjaminEJ

HerbertAG

2005 QT interval is a heritable quantitative trait with evidence of linkage to chromosome 3 in a genome-wide linkage analysis: The Framingham Heart Study. Heart Rhythm 2 277 284

29. PfeuferA

SannaS

ArkingDE

MüllerM

GatevaV

2009 Common variants at ten loci modulate the QT interval duration in the QTSCD Study. Nat Genet 41 407 414

30. de BruyneMC

HoesAW

KorsJA

HofmanA

van BemmelJH

1999 Prolonged QT interval predicts cardiac and all-cause mortality in the elderly. The Rotterdam Study. Eur Heart J 20 278 284

31. StrausSM

KorsJA

De BruinML

van der HooftCS

HofmanA

2006 Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol 47 362 367

32. JouvenX

EmpanaJP

SchwartzPJ

DesnosM

CourbonD

2005 Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 352 1951 1958

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2010 Číslo 7
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Získaná hemofilie - Povědomí o nemoci a její diagnostika
nový kurz

Eozinofilní granulomatóza s polyangiitidou
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#