Key result
Early repolarization patterns occur in ~34% of chest pain patients and link to lower BMI.
Why the study?
The early repolarization pattern, previously regarded as benign, has recently shown associations with adverse outcomes, including all-cause, arrhythmic, and cardiac mortality.
What is the frequency of and factors associated with early repolarization changes on ECG in patients presenting with chest pain?
Cross-Sectional (n=271)
No
What is the frequency of and factors associated with early repolarization changes on ECG in patients presenting with chest pain?
Odds Ratio: 0.85 (95% CI 0.77–0.94)
p-value: p=0.002
Early repolarization is a common ECG finding in patients presenting with chest pain, particularly those with non-cardiac diagnoses, and is associated with lower BMI, shorter T-wave duration, and lower heart rate.
Early repolarization patterns in chest pain patients should not alter management; leaves open their prognostic value as hypothesis-generating.
Objectives: The “early repolarization (ER)” pattern, previously regarded as benign, has recently shown associations with adverse outcomes, including all-cause, arrhythmic and cardiac mortality. This study aimed to assess the prevalence and factors linked to ER changes in the ECG among chest pain patients at a tertiary cardiac center. Methodology: We enrolled 271 patients aged 18-80 with chest pain complaints. Baseline 12-lead ECGs were used to assess the ER pattern. Multivariable binary logistic regression was conducted, and “odds ratios (OR)” with 95% “confidence intervals (CI)” were reported. Results: Of the 271 patients, 162 (59.8%) were male, with a mean age of 55.3 ± 10 years, and 40 (14.8%) were ≤45 years old. The ER pattern was present in 92 (33.9%) patients. The ER pattern was associated with low “body mass index (BMI)” (OR=0.85 [95% CI: 0.77 - 0.94; p=0.002]), shorter T-wave duration (OR=0.99 [95% CI: 0.98 - 1.00; p=0.008]), and lower heart rate (OR=0.94 [95% CI: 0.90 - 0.98; p=0.007]). Additionally, the odds of ER pattern were lower in patients with “ST-elevation myocardial infarction (STEMI)” (OR=0.23 [95% CI: 0.07 - 0.72; p=0.012]) and non-STEMI (OR=0.21 [95% CI: 0.07 - 0.63; p=0.006]) compared to non-cardiac chest pain. Conclusion: Early repolarization is a common ECG pattern in one-third of chest pain patients. Associated factors include low BMI, shorter T-wave duration, and lower heart rate, and it is less frequent in patients with STEMI and non-STEMI.
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Anoshi et al. (2023) conducted a cross-sectional in Chest pain (n=271). Body mass index (BMI) was evaluated on Presence of early repolarization pattern (OR 0.85, 95% CI 0.77-0.94, p=0.002). Early repolarization patterns were present in 33.9% of chest pain patients and were significantly associated with lower body mass index (OR 0.85), shorter T-wave duration, and lower heart rate.
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