Association between J-point elevation and death from coronary artery disease--15-year follow up of the NIPPON DATA90.
BACKGROUND
An early repolarization pattern, characterized by an elevation of the QRS-ST junction (J-point) on 12-lead electrocardiography (ECG) is associated with cardiac and sudden death. However, little is known about the prognostic significance of J-point elevation for various disease-specific cardiovascular outcomes, including coronary artery disease (CAD).


RESULTS
To investigate the association between the presence of J-point elevation≥0.1 mV and various disease-specific cardiovascular outcomes, we conducted a 15-year prospective study in a representative general Japanese population of 7,630 individuals (41% men, mean age 52.4 years) who participated in the National Survey of Circulatory Disorders. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. J-point elevation was present in 264 individuals (3.5%) and was associated with an increased risk of cardiac death (adjusted HR, 2.54; 95% confidence interval [CI] 1.40-4.58; P=0.002) and death from CAD (adjusted HR, 4.66; 95% CI 2.30-9.46; P<0.001). In a subgroup analysis by age, the association between J-point elevation and cardiovascular outcomes was more remarkable in middle-aged (<60 years) than in older individuals (≥60 years) (all P for interaction<0.05).


CONCLUSIONS
J-point elevation on standard 12-lead ECG was an independent predictor of cardiac death and death from CAD in a representative sample of the general Japanese population, particularly among the middle-aged.
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan. hisataka@belle.shiga-med.ac.jp
Takashi
T
Hisamatsu
Takayoshi
T
Ohkubo
Katsuyuki
K
Miura
Takashi
T
Yamamoto
Akira
A
Fujiyoshi
Naoko
N
Miyagawa
Aya
A
Kadota
Naoyuki
N
Takashima
Shin-ya
SY
Nagasawa
Yoshikuni
Y
Kita
Yoshitaka
Y
Murakami
Akira
A
Okayama
Minoru
M
Horie
Tomonori
T
Okamura
Hirotsugu
H
Ueshima
D000328:Adult; D000367:Age Factors; D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors