title: The impact of ST elevation on athletic screening.
abstract: OBJECTIVE
  To demonstrate the prevalence and patterns of ST elevation (STE) in ambulatory individuals and athletes and compare the clinical outcomes.
  
  
  METHODS
  Retrospective cohort study. ST elevation was measured by computer algorithm and defined as ≥0.1 mV at the end of the QRS complex. Elevation was confirmed, and J waves and slurring were coded visually.
  
  
  METHODS
  Veterans Affairs Palo Alto Health Care System and Stanford University varsity athlete screening evaluation.
  
  
  METHODS
  Overall, 45 829 electrocardiograms (ECGs) were obtained from the clinical patient cohort and 658 ECGs from athletes. We excluded inpatients and those with ECG abnormalities, leaving 20 901 outpatients and 641 athletes.
  
  
  METHODS
  Electrocardiogram evaluation and follow-up for vital status.
  
  
  METHODS
  All-cause and cardiovascular mortality and cardiac events.
  
  
  RESULTS
  ST elevation in the anterior and lateral leads was more prevalent in men and in African Americans and inversely related to age and resting heart rate. Athletes had a higher prevalence of early repolarization even when matched for age and gender with nonathletes. ST elevation greater than 0.2 mV (2 mm) was very unusual. ST elevation was not associated with cardiac death in the clinical population or with cardiac events or abnormal test results in the athletes.
  
  
  CONCLUSIONS
  Early repolarization is not associated with cardiac death and has patterns that help distinguish it from STE associated with cardiac conditions, such as myocardial ischemia or injury, pericarditis, and the Brugada syndrome.
authors: Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California 94305, USA. troyleo@gmail.com
authors: Troy
authors: T
authors: Leo
authors: Abhimanyu
authors: A
authors: Uberoi
authors: Nikhil A
authors: NA
authors: Jain
authors: Daniel
authors: D
authors: Garza
authors: Shilpy
authors: S
authors: Chowdhury
authors: James V
authors: JV
authors: Freeman
authors: Marco
authors: M
authors: Perez
authors: Euan
authors: E
authors: Ashley
authors: Victor
authors: V
authors: Froelicher
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013177:Sports / Q000502:physiology*; D055815:Young Adult