TY - JOUR
T1 - Relation of Early Repolarization (J Point Elevation) to Mortality in Blacks (from the Jackson Heart Study)
AU - Kelly, Jacob P.
AU - Greiner, Melissa
AU - Soliman, Elsayed Z.
AU - Randolph, Tiffany C.
AU - Thomas, Kevin L.
AU - Dunlay, Shannon M.
AU - Curtis, Lesley H.
AU - O'Brien, Emily C.
AU - Mentz, Robert J.
N1 - Funding Information:
This work was supported by grant R01HL117305 from the National Heart, Lung, and Blood Institute (Bethesda, Maryland). The Jackson Heart Study is supported by contracts HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, and HHSN268201300050C from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities (Bethesda, Maryland).
Funding Information:
Dr. Thomas receives research support from PCORI and is a consultant for Bristol-Myers Squibb, Pfizer, and Janssen Pharmaceuticals. Dr. Curtis receives funding from Boston Scientific, GlaxoSmithKline, Gilead, NCQA, and Novartis. Dr. O'Brien receives research support from the NIH, PCORI, Bristol-Myers Squibb, GlaxoSmithKline, Janssen Scientific, and Boehringer-Ingelheim and has served on an advisory board for Portola Pharmaceuticals. Dr. Mentz receives research support from Amgen, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Gilead, Novartis, Otsuka, and ResMed; honoraria from HeartWare, Janssen, Luitpold Pharmaceuticals, Novartis, ResMed, and Thoratec; and has served on an advisory board for Luitpold Pharmaceuticals, Inc. The other authors report no conflicts.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/7/15
Y1 - 2018/7/15
N2 - Conflicting data exist regarding the associations of early repolarization (ER) with electrocardiogram (ECG) and clinical outcomes in blacks. We examined the association of ER defined by J point elevation (JPE) and all-cause mortality, and heart failure (HF) hospitalization in blacks in the Jackson Heart Study (JHS) cohort. We included JHS participants with ECGs from the baseline visit coding JPE and excluded participants with paced rhythms or QRS duration ≥120 ms. We compared the cumulative incidence of 10-year all-cause mortality and 8-year HF hospitalization by presence of JPE ≥0.1 mV in any ECG lead at baseline using Kaplan-Meier estimates and multivariable Cox models. Of the 4,978 participants, 1,410 (28%) had JPE at baseline: anterior leads 97.8%, lateral leads 8.3%, and inferior leads 2.9%. Compared with participants without JPE, those with JPE were younger, more likely to be male and current smokers, and less likely to have hypertension. Over a median follow-up of 8 years, there were no significant differences in the cumulative incidence or multivariable-adjusted hazards of all-cause mortality or HF hospitalization in participants with and without JPE in any lead (adjusted hazard ratio 0.97, 95% confidence interval 0.89 to 1.52, and adjusted hazard ratio 1.18, 95% confidence interval 0.9 to 1.54, respectively). Of the 2,523 participants who completed Exam 3 without JPE at baseline, 246 (10%) developed JPE over follow-up. In conclusion, JPE on ECG was not associated with long-term mortality or HF hospitalization in a large prospective black community cohort, suggesting that ER may represent a benign ECG finding in blacks.
AB - Conflicting data exist regarding the associations of early repolarization (ER) with electrocardiogram (ECG) and clinical outcomes in blacks. We examined the association of ER defined by J point elevation (JPE) and all-cause mortality, and heart failure (HF) hospitalization in blacks in the Jackson Heart Study (JHS) cohort. We included JHS participants with ECGs from the baseline visit coding JPE and excluded participants with paced rhythms or QRS duration ≥120 ms. We compared the cumulative incidence of 10-year all-cause mortality and 8-year HF hospitalization by presence of JPE ≥0.1 mV in any ECG lead at baseline using Kaplan-Meier estimates and multivariable Cox models. Of the 4,978 participants, 1,410 (28%) had JPE at baseline: anterior leads 97.8%, lateral leads 8.3%, and inferior leads 2.9%. Compared with participants without JPE, those with JPE were younger, more likely to be male and current smokers, and less likely to have hypertension. Over a median follow-up of 8 years, there were no significant differences in the cumulative incidence or multivariable-adjusted hazards of all-cause mortality or HF hospitalization in participants with and without JPE in any lead (adjusted hazard ratio 0.97, 95% confidence interval 0.89 to 1.52, and adjusted hazard ratio 1.18, 95% confidence interval 0.9 to 1.54, respectively). Of the 2,523 participants who completed Exam 3 without JPE at baseline, 246 (10%) developed JPE over follow-up. In conclusion, JPE on ECG was not associated with long-term mortality or HF hospitalization in a large prospective black community cohort, suggesting that ER may represent a benign ECG finding in blacks.
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U2 - 10.1016/j.amjcard.2018.04.004
DO - 10.1016/j.amjcard.2018.04.004
M3 - Article
C2 - 29866580
AN - SCOPUS:85047837628
VL - 122
SP - 340
EP - 346
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 2
ER -