Is more aggressive prevention of coronary artery disease required for patients with early repolarization syndrome?

摘要

We were pleased to read the study by Hisamatsu et al,1 which has shed some light on this particular subject. The authors propose that J-point elevation on a standard 12-lead ECG is significantly associated with an increased risk of death from cardiac causes, particularly from coronary artery disease (CAD), after adjustment for potential confounders. Their findings corroborate those of different investigators who have shown that patients with early repolarization (ER) syndromes are at higher mortality risk during the acute phase of a myocardial infarction (MI). In fact, the presence of ER has been connected to a higher vulnerability to fatal ventricular arrhythmias during the acute phase of MI. J-waves may represent delayed depolarization similar to that seen in peri-infarction block or dispersed heterogeneous repolarization, both of which increase the risk of arrhythmic mortality.