The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population
Eric Shulman, Philip Aagaard, Faraj Kargoli, Ethan Hoch, Luigi Di Biase, John Fisher, Jay Gross, Soo Kim, Eugen Palma, Kevin J. Ferrick, Andrew Krumerman
Background Early repolarization (ER), once thought to be a benign finding on electrocardiograph (ECG), has recently been associated with an increased risk of sudden cardiac death. As there are limited data in the Hispanic population, we investigated possible associations between automated ECG ER readings and overall mortality, using the classic definition involving J-point elevation with ST segment elevation. Methods An ECG and electronic medical record (EMR) database from a regional medical center was interrogated. Inclusion criteria included Hispanic ethnicity and age over 18 from 2000 to 2011. A Cox model assessed the outcome of death. Varying morphological characteristics of ER were analyzed for high-risk features. Results There were n = 33,944 Hispanics of who n = 532 (1.6%) had ER with a mean follow-up period of 5.29 years. After adjustment for demographic, clinical, lifestyle, and laboratory variables, ER was not significantly related to all-cause mortality (hazard ratio [HR]: 1.18, 95% confidence interval [CI]: 0.90-1.54, P = 0.23). However, mortality risk of ER varied by gender and age (P interaction = 0.007). The risk of ER for mortality was highest for females (HR: 2.01, CI: 1.39-3.10, P = 0.001), with the highest overall risk for women over the age of 75 (HR: 2.09, CI: 1.12-3.92, P = 0.021) compared to women under age 75 (HR: 1.72, CI: 0.95-3.11, P = 0.075). Conclusions ER is not associated with an increased risk of death in the overall Hispanic population. However, our analysis suggests a higher risk of overall mortality in the elderly Hispanic female population with ER.
PACE - Pacing and Clinical Electrophysiology
https://doi.org/10.1111/pace.12730
electrophysiology - clinical
10.1111/pace.12730
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Hispanic Americans Medicine & Life Sciences 100%
Electrocardiography Medicine & Life Sciences 36%
Sudden Cardiac Death Medicine & Life Sciences 16%
Electronic Health Records Medicine & Life Sciences 15%
Proportional Hazards Models Medicine & Life Sciences 13%
Shulman, E., Aagaard, P., Kargoli, F., Hoch, E., Biase, L. D., Fisher, J., Gross, J., Kim, S., Palma, E., Ferrick, K. J., & Krumerman, A. (2015). The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population. PACE - Pacing and Clinical Electrophysiology, 38(12), 1396-1404. https://doi.org/10.1111/pace.12730
The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population. / Shulman, Eric; Aagaard, Philip; Kargoli, Faraj et al.
In: PACE - Pacing and Clinical Electrophysiology, Vol. 38, No. 12, 01.12.2015, p. 1396-1404.
Shulman, E, Aagaard, P, Kargoli, F, Hoch, E, Biase, LD, Fisher, J, Gross, J, Kim, S, Palma, E, Ferrick, KJ & Krumerman, A 2015, 'The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population', PACE - Pacing and Clinical Electrophysiology, vol. 38, no. 12, pp. 1396-1404. https://doi.org/10.1111/pace.12730
Shulman E, Aagaard P, Kargoli F, Hoch E, Biase LD, Fisher J et al. The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population. PACE - Pacing and Clinical Electrophysiology. 2015 Dec 1;38(12):1396-1404. doi: 10.1111/pace.12730
Shulman, Eric ; Aagaard, Philip ; Kargoli, Faraj et al. / The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population. In: PACE - Pacing and Clinical Electrophysiology. 2015 ; Vol. 38, No. 12. pp. 1396-1404.
@article{b4c88667800b4769bb8caee354360f63,
title = "The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population",
abstract = "Background Early repolarization (ER), once thought to be a benign finding on electrocardiograph (ECG), has recently been associated with an increased risk of sudden cardiac death. As there are limited data in the Hispanic population, we investigated possible associations between automated ECG ER readings and overall mortality, using the classic definition involving J-point elevation with ST segment elevation. Methods An ECG and electronic medical record (EMR) database from a regional medical center was interrogated. Inclusion criteria included Hispanic ethnicity and age over 18 from 2000 to 2011. A Cox model assessed the outcome of death. Varying morphological characteristics of ER were analyzed for high-risk features. Results There were n = 33,944 Hispanics of who n = 532 (1.6%) had ER with a mean follow-up period of 5.29 years. After adjustment for demographic, clinical, lifestyle, and laboratory variables, ER was not significantly related to all-cause mortality (hazard ratio [HR]: 1.18, 95% confidence interval [CI]: 0.90-1.54, P = 0.23). However, mortality risk of ER varied by gender and age (P interaction = 0.007). The risk of ER for mortality was highest for females (HR: 2.01, CI: 1.39-3.10, P = 0.001), with the highest overall risk for women over the age of 75 (HR: 2.09, CI: 1.12-3.92, P = 0.021) compared to women under age 75 (HR: 1.72, CI: 0.95-3.11, P = 0.075). Conclusions ER is not associated with an increased risk of death in the overall Hispanic population. However, our analysis suggests a higher risk of overall mortality in the elderly Hispanic female population with ER.",
keywords = "data analysis, databases, electrocardiogram, electrophysiology - clinical",
author = "Eric Shulman and Philip Aagaard and Faraj Kargoli and Ethan Hoch and Biase, {Luigi Di} and John Fisher and Jay Gross and Soo Kim and Eugen Palma and Ferrick, {Kevin J.} and Andrew Krumerman",
note = "Publisher Copyright: {\textcopyright} 2015 Wiley Periodicals, Inc. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.",
doi = "10.1111/pace.12730",
journal = "PACE - Pacing and Clinical Electrophysiology",
T1 - The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population
AU - Shulman, Eric
AU - Aagaard, Philip
AU - Kargoli, Faraj
AU - Hoch, Ethan
AU - Biase, Luigi Di
AU - Fisher, John
AU - Gross, Jay
AU - Kim, Soo
AU - Palma, Eugen
AU - Ferrick, Kevin J.
AU - Krumerman, Andrew
N1 - Publisher Copyright: © 2015 Wiley Periodicals, Inc. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.
N2 - Background Early repolarization (ER), once thought to be a benign finding on electrocardiograph (ECG), has recently been associated with an increased risk of sudden cardiac death. As there are limited data in the Hispanic population, we investigated possible associations between automated ECG ER readings and overall mortality, using the classic definition involving J-point elevation with ST segment elevation. Methods An ECG and electronic medical record (EMR) database from a regional medical center was interrogated. Inclusion criteria included Hispanic ethnicity and age over 18 from 2000 to 2011. A Cox model assessed the outcome of death. Varying morphological characteristics of ER were analyzed for high-risk features. Results There were n = 33,944 Hispanics of who n = 532 (1.6%) had ER with a mean follow-up period of 5.29 years. After adjustment for demographic, clinical, lifestyle, and laboratory variables, ER was not significantly related to all-cause mortality (hazard ratio [HR]: 1.18, 95% confidence interval [CI]: 0.90-1.54, P = 0.23). However, mortality risk of ER varied by gender and age (P interaction = 0.007). The risk of ER for mortality was highest for females (HR: 2.01, CI: 1.39-3.10, P = 0.001), with the highest overall risk for women over the age of 75 (HR: 2.09, CI: 1.12-3.92, P = 0.021) compared to women under age 75 (HR: 1.72, CI: 0.95-3.11, P = 0.075). Conclusions ER is not associated with an increased risk of death in the overall Hispanic population. However, our analysis suggests a higher risk of overall mortality in the elderly Hispanic female population with ER.
AB - Background Early repolarization (ER), once thought to be a benign finding on electrocardiograph (ECG), has recently been associated with an increased risk of sudden cardiac death. As there are limited data in the Hispanic population, we investigated possible associations between automated ECG ER readings and overall mortality, using the classic definition involving J-point elevation with ST segment elevation. Methods An ECG and electronic medical record (EMR) database from a regional medical center was interrogated. Inclusion criteria included Hispanic ethnicity and age over 18 from 2000 to 2011. A Cox model assessed the outcome of death. Varying morphological characteristics of ER were analyzed for high-risk features. Results There were n = 33,944 Hispanics of who n = 532 (1.6%) had ER with a mean follow-up period of 5.29 years. After adjustment for demographic, clinical, lifestyle, and laboratory variables, ER was not significantly related to all-cause mortality (hazard ratio [HR]: 1.18, 95% confidence interval [CI]: 0.90-1.54, P = 0.23). However, mortality risk of ER varied by gender and age (P interaction = 0.007). The risk of ER for mortality was highest for females (HR: 2.01, CI: 1.39-3.10, P = 0.001), with the highest overall risk for women over the age of 75 (HR: 2.09, CI: 1.12-3.92, P = 0.021) compared to women under age 75 (HR: 1.72, CI: 0.95-3.11, P = 0.075). Conclusions ER is not associated with an increased risk of death in the overall Hispanic population. However, our analysis suggests a higher risk of overall mortality in the elderly Hispanic female population with ER.
KW - data analysis
KW - databases
KW - electrocardiogram
KW - electrophysiology - clinical
U2 - 10.1111/pace.12730
DO - 10.1111/pace.12730
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology