Abstract
The aim of this of this meta-analysis was to examine the potential association between certain early repolarization (ER) characteristics and ventricular tachyarrhythmias (VTAs) in patients with acute myocardial infarction (AMI). We searched PubMed, Embase and Web of Science databases for records published until December 2014. Of the 658 initially identified records, 7 studies with a total of 1,565 patients (299 with ER and 1,266 without ER) were finally analyzed. Overall, patients with ER displayed a higher risk of VTAs following AMI compared to patients without ER [odds ratio (OR): 3.75, 95% CI: 2.62–5.37, p < 0.00001]. Subgroup analyses showed that the diagnosis of ER prior to AMI onset is a better predictor of VTAs (OR: 5.70, p < 0.00001) compared to those diagnosed after AMI onset (OR: 2.60, p = 0.00001). Remarkably, a notching morphology was a significant predictor of VTAs compared to slurring morphology (OR: 3.85, p = 0.002). Finally, an inferior ER location (OR: 8.85, p < 0.00001) was significantly associated with increased risk of VTAs in AMI patients. In conclusion, our meta-analysis suggests that ER pattern is associated with greater risk of VTAs in patients with AMI. A notched ER pattern located in inferior leads confers the highest risk for VTAs in AMI.
Highlights
(diagnosis of early repolarization (ER) before or after acute myocardial infarction (AMI) onset, J-point morphology, and lead distribution) in predicting the occurrence of ventricular tachyarrhythmias (VTAs) in patients with AMI needs further investigation
Individual case reports, review articles and editorials were excluded; (4) assessed ER and documented VTAs in the setting of AMI; (5) clearly defined endpoint events, such as non-sustained ventricular tachycardia (VT), sustained VT and ventricular fibrillation (VF); (6) reporting the odds ratios (ORs) or hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) or data necessary to calculate these for ER in AMI patients were reported
We found that notching morphology and inferior ER location are both significantly associated with 8- and 9-fold increased risk for VTAs, respectively
Summary
Meta-analyses of observational studies present particular challenges because of inherent biases and differences in study designs. We extracted all the adjusted and unadjusted (if the adjusted OR/HR were not applicable) OR/HR and the corresponding 95% CI or data necessary to calculate it in this way (categorical) to evaluate ER in predicting the risk of VTAs in the setting of AMI. Subgroup analyses regarding the diagnosis of ER in relation to AMI onset (before AMI ER and after AMI ER), the morphology of J-point (notching or slurring), the location of ER (inferior leads), the follow-up duration for detection of VTAs (≤ 48 hours or > 48 hours) and if the studies solely included the patients with STEMI were performed. All statistical analyses were performed with the use of Review Manager version 5.3
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
