The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Association of Early Repolarization Pattern on ECG with Risk of Cardiac and All-Cause Mortality: A Population-Based Prospective Cohort Study (MONICA/KORA)
Open accessAbstract
BACKGROUND: Early repolarization pattern (ERP) on electrocardiogram was associated with idiopathic ventricular fibrillation and sudden cardiac arrest in a case-control study and with cardiovascular mortality in a Finnish community-based sample. We sought to determine ERP prevalence and its association with cardiac and all-cause mortality in a large, prospective, population-based case-cohort study (Monitoring of Cardiovascular Diseases and Conditions [MONICA]/KORA [Cooperative Health Research in the Region of Augsburg]) comprised of individuals of Central-European descent. METHODS AND FINDINGS: Electrocardiograms of 1,945 participants aged 35-74 y, representing a source population of 6,213 individuals, were analyzed applying a case-cohort design. Mean follow-up was 18.9 y. Cause of death was ascertained by the 9th revision of the International Classification of Disease (ICD-9) codes as documented in death certificates. ERP-attributable effects on mortality were determined by a weighted Cox proportional hazard model adjusted for covariables. Prevalence of ERP was 13.1% in our study. ERP was associated with cardiac and all-cause mortality, most pronounced in those of younger age and male sex; a clear ERP-age interaction was detected (p = 0.005). Age-stratified analyses showed hazard ratios (HRs) for cardiac mortality of 1.96 (95% confidence interval [CI] 1.05-3.68, p = 0.035) for both sexes and 2.65 (95% CI 1.21-5.83, p = 0.015) for men between 35-54 y. An inferior localization of ERP further increased ERP-attributable cardiac mortality to HRs of 3.15 (95% CI 1.58-6.28, p = 0.001) for both sexes and to 4.27 (95% CI 1.90-9.61, p<0.001) for men between 35-54 y. HRs for all-cause mortality were weaker but reached significance. CONCLUSIONS: We found a high prevalence of ERP in our population-based cohort of middle-aged individuals. ERP was associated with about a 2- to 4-fold increased risk of cardiac mortality in individuals between 35 and 54 y. An inferior localization of ERP was associated with a particularly increased risk. Please see later in the article for the Editors' Summary.
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“Furthermore, it has been shown in population-based studies to be associated with increased risk of cardiac death (352,353,355–357).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [357]
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Cites
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297
Proportional hazards tests and diagnostics based on weighted residuals
GRAMBSCH, P. M., & THERNEAU, T. M. (1994) · Biometrika · doi:10.1093/biomet/81.3.515 · Cited by 5,885 · cited 1×
“The latter was identified to have a strongly time-dependent effect on mortality using a test based on scaled Schoenfeld residuals [19].”
MethodWHO MONICA Project Principal Invest (1988) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(88)90084-4 · Cited by 1,846
Sudden Death Due to Cardiac Arrhythmias
Huikuri, H. V., Castellanos, A., & Myerburg, R. J. (2001) · New England Journal of Medicine · doi:10.1056/nejmra000650 · Cited by 1,490 · cited 1×
“Cardiovascular diseases are the main cause of death in the industrialized world, and in approximately 50% of deaths due to cardiovascular causes, SCD, mostly due to ventricular arrhythmias, is considered the underlying reason [9,10].”
BackgroundSudden Cardiac Arrest Associated with Early Repolarization
Haïssaguerre, M., Derval, N., Sacher, F., Jesel, L., Deisenhofer, I., de Roy, L., Pasquié, J.-L., Nogami, A., Babuty, D., Yli-Mayry, S., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa071968 · Cited by 1,449 · cited 4×
“However, this judgment was seriously questioned by both (1) a study, in which ERP was found to be a clinically relevant ECG signature, and possibly a marker of SCD, in the evaluation of unexplained syncope or idiopathic ventricular fibrillation in patients without structural heart disease [7], and (2) the recent repor…”
MethodResultInfluentialKornitzer, M., Berghmans, L., Wilmet, M. D., Darquennes, H., Lagasse, R., & Payen, R. (1988) · Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) · Cited by 1,270
Wada, K., Tanaka, K., & Nakashima, K. (2011) · PubMed · Cited by 1,132
Heart-Rate Profile during Exercise as a Predictor of Sudden Death
Jouven, X., Empana, J. P., Schwartz, P. J., Desnos, M., Courbon, D., & Ducimetière, P. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043012 · Cited by 1,023
Long-Term Outcome Associated with Early Repolarization on Electrocardiography
Tikkanen, J. T., Anttonen, O. M., Junttila, J. M., Aro, A. L., Kerola, T. V., Rissanen, H. A., Reunanen, A., & Huikuri, H. V. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0907589 · Cited by 842 · cited 1×
“. Recently, a community-based investigation of Finnish individuals demonstrated a slightly increased cardiovascular mortality associated with ERP”
Background
Research works printed but not linked: 3
- B Thorand, 2005, Case-cohort studies: an effective design for the investigation of biomarkers as risk factors for chronic diseases–demonstrated by the example of the MONICA/KORA Augsburg Case-Cohort Study 1984–2002., Gesundheitswesen, 67, S98
- U Vinsonneau, 2009, Prevalence of the early repolarization aspect in a healthy women population., Eur Heart J, 30, 167
- R Eckart, 2006, Causes of sudden death in young female military recruits., Am J Cardiol, 97, 1756
Cited by
Sorted by citations
Zeppenfeld, K., Tfelt‐Hansen, J., Riva, M., Winkel, B. G., Behr, E. R., Blom, N. A., Charron, P., Corrado, D., Dagres, N., de Chillou, C., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehac262 · Cited by 3,432
Self-citationPriori, S. G., Wilde, A. A., Horie, M., Cho, Y., Behr, E. R., Berul, C., Blom, N., Brugada, J., Chiang, C.-E., Huikuri, H., et al. (2013) · Heart Rhythm · doi:10.1016/j.hrthm.2013.05.014 · Cited by 1,942
“© Heart Rhythm Society, European Heart Rhythm Association, a registered branch of the European Society of Cardiology, and the Asia Pacific Heart Rhythm Society 28 ER ECG pattern (> 1 mm) in the inferior/lateral leads occurs in 1-13% of the general population and in 15-70% of idiopathic VF cases [153-161].”
InfluentialThe Spectrum of Epidemiology Underlying Sudden Cardiac Death
Hayashi, M., Shimizu, W., & Albert, C. M. (2015) · Circulation Research · doi:10.1161/circresaha.116.304521 · Cited by 741
J Wave Syndromes Consensus Conference: Emerging Concepts & Gaps in Knowledge
Antzelevitch, C., Yan, G.-X., Ackerman, M., Borggrefe, M., Corrado, D., Guo, J.-H., Gussak, I., Hasdemir, C., Horie, M., Huikuri, H., et al. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2016.05.024 · Cited by 239
Priori, S. G., Wilde, A. A. M., Horie, M., Cho, Y., Behr, E. R., Berul, C. I., Blom, N. A., Brugada, J., Chiang, C., Huikuri, H. V., et al. (2013) · EP Europace · doi:10.1093/europace/eut272 · Cited by 626
Metadata
- Authors
- Sinner, M. F., Reinhard, W., Müller, M., Beckmann, B.-M., Martens, E., Perz, S., Pfeufer, A., Winogradow, J., Stark, K., Meisinger, C., Wichmann, H.-E., Peters, A., Riegger, G. A. J., Steinbeck, G., Hengstenberg, C., & Kääb, S.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- University Hospital Regensburg (DE)
- Helmholtz Munich (DE)
- Corresponding author
- Kääb, Stefan
- ORCID
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2010-07-27
- Volume
- 7
- Issue
- 7
- Pages
- e1000314
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC2910598
- OpenAlex
- W2133142369
- Cited by
- 282
- References
- 35
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 12 · 2021: 6 · 2020: 11 · 2019: 18 · 2018: 14 · 2017: 25 · 2016: 32 · 2015: 26 · 2014: 19 · 2013: 39 · 2012: 24
- FWCI
- 20.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Site cant be reached (submittedVersion, cc-by)
- OPUS (Augsburg University) (submittedVersion, cc-by)
- Funders
- Deutsche Forschungsgemeinschaft
- Fondation Leducq (01GS0838)
- Bundesministerium für Bildung und Forschung (01GS0499, 01GS0838)
- Münchner Zentrum für Gesundheitswissenschaften
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- early repolarization, electrocardiogram, cardiac mortality, all-cause mortality, sudden cardiac death, age-stratified risk, sex differences, middle-aged adults, cardiovascular risk factors, Central European population, idiopathic ventricular fibrillation, sudden cardiac arrest, cardiovascular disease monitoring, cardiovascular disease prevention, cardiovascular disease treatment
- MeSH terms
- Adult, Aged, Cause of Death, Electrocardiography, Female, Germany, Heart Diseases, Humans, Male, Middle Aged, Population, Population Surveillance, Prospective Studies, Risk, Time Factors, Cohort Studies, Case-Control Studies
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