Frequency and Factors Associated with Early Repolarization Changes in ECG in Patients Presenting With Chest Pain

Authors

  • Anoshi Anoshi National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Shakir Zada National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Kamran Ahmed Khan National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Sumera Rajpoot National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Poonam Bai National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Paras Nazir National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Sorath Sorath Jinnah Sindh Medical University, Karachi, Pakistan
  • Pashmina Kumari Jinnah Postgraduate Medical Centre, Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v56i4.2668

Abstract

Objectives: The “early repolarization (ER)” pattern, previously regarded as benign, has recently shown associations with adverse outcomes, including all-cause, arrhythmic and cardiac mortality. This study aimed to assess the prevalence and factors linked to ER changes in the ECG among chest pain patients at a tertiary cardiac center.

Methodology: We enrolled 271 patients aged 18-80 with chest pain complaints. Baseline 12-lead ECGs were used to assess the ER pattern. Multivariable binary logistic regression was conducted, and “odds ratios (OR)” with 95% “confidence intervals (CI)” were reported.

Results: Of the 271 patients, 162 (59.8%) were male, with a mean age of 55.3 ± 10 years, and 40 (14.8%) were ≤45 years old. The ER pattern was present in 92 (33.9%) patients. The ER pattern was associated with low “body mass index (BMI)” (OR=0.85 [95% CI: 0.77 - 0.94; p=0.002]), shorter T-wave duration (OR=0.99 [95% CI: 0.98 - 1.00; p=0.008]), and lower heart rate (OR=0.94 [95% CI: 0.90 - 0.98; p=0.007]). Additionally, the odds of ER pattern were lower in patients with “ST-elevation myocardial infarction (STEMI)” (OR=0.23 [95% CI: 0.07 - 0.72; p=0.012]) and non-STEMI (OR=0.21 [95% CI: 0.07 - 0.63; p=0.006]) compared to non-cardiac chest pain.

Conclusion: Early repolarization is a common ECG pattern in one-third of chest pain patients. Associated factors include low BMI, shorter T-wave duration, and lower heart rate, and it is less frequent in patients with STEMI and non-STEMI.

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Published

2023-12-31

How to Cite

1.
Anoshi A, Zada S, Khan KA, Rajpoot S, Bai P, Nazir P, Sorath S, Kumari P. Frequency and Factors Associated with Early Repolarization Changes in ECG in Patients Presenting With Chest Pain. Pak Heart J [Internet]. 2023Dec.31 [cited 2024Jul.13];56(4):261-7. Available from: https://pakheartjournal.com/index.php/pk/article/view/2668

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Section

Original Article