Association Between J-Point Elevation and Death From Coronary Artery Disease – 15-Year Follow-up of the NIPPON DATA90 –

Takashi Hisamatsu; Takayoshi Ohkubo; Katsuyuki Miura; Takashi Yamamoto; Akira Fujiyoshi; Naoko Miyagawa; Aya Kadota; Naoyuki Takashima; Shin-ya Nagasawa; Yoshikuni Kita; Yoshitaka Murakami; Akira Okayama; Minoru Horie; Tomonori Okamura; Hirotsugu Ueshima; for the NIPPON DATA90 Research Group

doi:10.1253/circj.CJ-12-1273

Ischemic Heart Disease

Association Between J-Point Elevation and Death From Coronary Artery Disease

– 15-Year Follow-up of the NIPPON DATA90 –

Takashi Hisamatsu, Takayoshi Ohkubo, Katsuyuki Miura, Takashi Yamamoto, Akira Fujiyoshi, Naoko Miyagawa, Aya Kadota, Naoyuki Takashima, Shin-ya Nagasawa, Yoshikuni Kita, Yoshitaka Murakami, Akira Okayama, Minoru Horie, Tomonori Okamura, Hirotsugu Ueshima, for the NIPPON DATA90 Research Group

Author information

Takashi Hisamatsu
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
Department of Health Science, Shiga University of Medical Science
Takayoshi Ohkubo
Department of Health Science, Shiga University of Medical Science
Katsuyuki Miura
Department of Health Science, Shiga University of Medical Science
Takashi Yamamoto
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
Akira Fujiyoshi
Department of Health Science, Shiga University of Medical Science
Naoko Miyagawa
Department of Health Science, Shiga University of Medical Science
Aya Kadota
Department of School Nursing and Health Education, Osaka Kyoiku University
Naoyuki Takashima
Department of Health Science, Shiga University of Medical Science
Shin-ya Nagasawa
Department of Epidemiology and Public Health, Kanazawa Medical University
Yoshikuni Kita
Department of Health Science, Shiga University of Medical Science
Yoshitaka Murakami
Department of Medical Statistics, Shiga University of Medical Science
Akira Okayama
First Institute for Health Promotion and Health Care
Minoru Horie
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
Tomonori Okamura
Department of Preventive Medicine and Public Health, School of Medicine, Keio University
Hirotsugu Ueshima
Department of Health Science, Shiga University of Medical Science
Lifestyle-Related Disease Prevention Center, Shiga University of Medical Science
for the NIPPON DATA90 Research Group

Keywords: Cardiovascular diseases, Coronary artery disease, Electrocardiography, Epidemiology, J-point

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Supplementary material

2013 Volume 77 Issue 5 Pages 1260-1266

DOI https://doi.org/10.1253/circj.CJ-12-1273

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Abstract

Background: An early repolarization pattern, characterized by an elevation of the QRS-ST junction (J-point) on 12-lead electrocardiography (ECG) is associated with cardiac and sudden death. However, little is known about the prognostic significance of J-point elevation for various disease-specific cardiovascular outcomes, including coronary artery disease (CAD). Methods and Results: To investigate the association between the presence of J-point elevation ≥0.1mV and various disease-specific cardiovascular outcomes, we conducted a 15-year prospective study in a representative general Japanese population of 7,630 individuals (41% men, mean age 52.4 years) who participated in the National Survey of Circulatory Disorders. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. J-point elevation was present in 264 individuals (3.5%) and was associated with an increased risk of cardiac death (adjusted HR, 2.54; 95% confidence interval [CI] 1.40–4.58; P=0.002) and death from CAD (adjusted HR, 4.66; 95% CI 2.30–9.46; P<0.001). In a subgroup analysis by age, the association between J-point elevation and cardiovascular outcomes was more remarkable in middle-aged (<60 years) than in older individuals (≥60 years) (all P for interaction <0.05). Conclusions: J-point elevation on standard 12-lead ECG was an independent predictor of cardiac death and death from CAD in a representative sample of the general Japanese population, particularly among the middle-aged. (Circ J 2013; 77: 1260–1266)

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