Early repolarization pattern in patients with malignant coronary artery anomalies

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Medical Imaging

Background:

• Potentially malignant coronary artery anomalies (CAAs) can cause life-threatening complications.
• Early repolarization pattern (ERP) is a known risk factor for sudden cardiac death (SCD).
• The association between ERP and adverse outcomes in malignant CAAs requires further investigation.

Purpose of the Study:

• To evaluate the relationship between ERP and poor cardiac outcomes in patients diagnosed with malignant CAAs.
• To identify electrocardiographic predictors of major adverse cardiac events (MACE) in this patient cohort.

Main Methods:

• Retrospective analysis of imaging findings, electrocardiographic features, clinical data, and long-term outcomes.
• Primary outcome: Major Adverse Cardiac Events (MACE) including fatal ventricular arrhythmias (VAs), syncope, or SCD.
• Secondary outcome: Fatal VAs or SCD. Patients were grouped as MACE (+) or MACE (-).

Main Results:

• 139 patients with malignant CAAs were included (mean age 54.5 years, 52.5% male).
• 11.5% of patients experienced at least one MACE.
• Interarterial course (IAC) anomalies and ERP were significantly more frequent in the MACE (+) group.
• ERP was an independent predictor of MACE (HR=4.06) and SCD/fatal VAs (HR=6.45).

Conclusions:

• Early repolarization pattern (ERP) may be associated with adverse cardiac outcomes in patients with malignant coronary artery anomalies (CAAs).
• ERP is an independent predictor for MACE and SCD/fatal VAs in this population.
• Causality cannot be established due to the retrospective observational nature of the study.