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Early Repolarization Pattern Predicts the Increased Risk of Ventricular Arrhythmias in Patients With Acute Anterior
Qi Chen1,2, Mingqi Zheng3, Gang Liu3
1Department of Cardiology, Military General Hospital of Beijing PLA.
Insights
Early repolarization pattern (ERP) increases the risk of life-threatening ventricular arrhythmias, specifically sustained ventricular tachycardia/ventricular fibrillation, in patients experiencing acute anterior ST-segment elevation myocardial infarction (STEMI). This finding highlights ERP as a significant predictor of adverse cardiac events within 30 days post-STEMI.
Area of Science:
- Cardiology
- Electrophysiology
- Critical Care Medicine
Background:
- The relationship between early repolarization pattern (ERP) and ventricular arrhythmias in ST-segment elevation myocardial infarction (STEMI) patients is not fully understood.
- This study investigates ERP as a potential predictor of sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) in acute anterior STEMI.
Purpose of the Study:
- To determine if the presence of an early repolarization pattern (ERP) predicts the risk of sustained ventricular tachycardia (VT)/ventricular fibrillation (VF) in patients with acute anterior ST-segment elevation myocardial infarction (STEMI).
Main Methods:
- 1,460 patients with acute anterior STEMI were enrolled.
- Propensity score matching created ERP-positive (183 patients) and ERP-negative (471 patients) groups.
- Kaplan-Meier analysis and multivariable Cox regression assessed the risk of VT/VF, heart failure, major adverse cardiovascular events, and all-cause death.
Main Results:
- Kaplan-Meier analysis indicated that ERP significantly increased the risk of sustained VT/VF within 30 days (log-rank P=0.00065).
- Multivariable Cox regression, adjusted for baseline confounding factors, revealed that ERP was associated with a 2.915-fold increased risk of sustained VT/VF (95% CI: 1.520-5.588, P=0.001).
Conclusions:
- The presence of ERP is independently associated with an increased risk of sustained VT/VF in patients with anterior STEMI during the initial 30-day period.
- ERP serves as a valuable predictor for identifying high-risk patients who may develop life-threatening ventricular arrhythmias after acute anterior STEMI.
Background:
The association between the early repolarization pattern (ERP) and ventricular arrhythmias in patients with ST-segment elevation myocardial infarction (STEMI) remains uncertain. We hypothesized that ERP predicts the risk of sustained ventricular tachycardia (VT)/ventricular fibrillation (VF) during the acute phase of anterior STEMI.
Methods And Results:
We enrolled 1,460 consecutive patients with acute anterior STEMI. We identified an ERP-positive group and a 1:6 propensity-matched ERP-negative group of 183 and 471, respectively. Comparisons of sustained VT/VF, heart failure, major adverse cardiovascular events and all-cause death were based on Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression with adjustment for unmatched confounding factors. In our full matching propensity score cohorts, there were 8 out of 28 variables not matching between the 2 groups. The Kaplan-Meier curves showed ERP increased the risk of sustained VT/VF in 30 days (log-rank test P=0.00065). Adjusted for baseline unmatched confounding risk, the Cox hazards regression analysis showed sustained VT/VF was associated with the present of ERP (hazard ratio=2.915, 95% CI: 1.520-5.588, P=0.001).
Conclusions:
In a propensity score-adjusted cohort the presence of ERP had a multivariable-adjusted association with increased risk of sustained VT/VF in patients with anterior STEMI in the early 30 days.