title: The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population.
abstract: BACKGROUND
  Early repolarization (ER), once thought to be a benign finding on electrocardiograph (ECG), has recently been associated with an increased risk of sudden cardiac death. As there are limited data in the Hispanic population, we investigated possible associations between automated ECG ER readings and overall mortality, using the classic definition involving J-point elevation with ST segment elevation.
  
  
  METHODS
  An ECG and electronic medical record (EMR) database from a regional medical center was interrogated. Inclusion criteria included Hispanic ethnicity and age over 18 from 2000 to 2011. A Cox model assessed the outcome of death. Varying morphological characteristics of ER were analyzed for high-risk features.
  
  
  RESULTS
  There were n = 33,944 Hispanics of who n = 532 (1.6%) had ER with a mean follow-up period of 5.29 years. After adjustment for demographic, clinical, lifestyle, and laboratory variables, ER was not significantly related to all-cause mortality (hazard ratio [HR]: 1.18, 95% confidence interval [CI]: 0.90-1.54, P = 0.23). However, mortality risk of ER varied by gender and age (P interaction = 0.007). The risk of ER for mortality was highest for females (HR: 2.01, CI: 1.39-3.10, P = 0.001), with the highest overall risk for women over the age of 75 (HR: 2.09, CI: 1.12-3.92, P = 0.021) compared to women under age 75 (HR: 1.72, CI: 0.95-3.11, P = 0.075).
  
  
  CONCLUSIONS
  ER is not associated with an increased risk of death in the overall Hispanic population. However, our analysis suggests a higher risk of overall mortality in the elderly Hispanic female population with ER.
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Eric
authors.initials: E
authors.lastname: Shulman
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Philip
authors.initials: P
authors.lastname: Aagaard
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Faraj
authors.initials: F
authors.lastname: Kargoli
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Ethan
authors.initials: E
authors.lastname: Hoch
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Luigi D I
authors.initials: LD
authors.lastname: Biase
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: John
authors.initials: J
authors.lastname: Fisher
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Jay
authors.initials: J
authors.lastname: Gross
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Soo
authors.initials: S
authors.lastname: Kim
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Eugen
authors.initials: E
authors.lastname: Palma
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Ferrick
authors.affiliation:  Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: Andrew
authors.initials: A
authors.lastname: Krumerman
mesh_terms: D017677:Age Distribution; D016757:Death, Sudden, Cardiac / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000208:ethnology* / Q000401:mortality*; D009518:New York / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D015996:Survival Rate
keywords: data analysis; databases; electrocardiogram; electrophysiology - clinical