Electrocardiographic J Wave and Cardiovascular Outcomes in the General Population (from the Atherosclerosis Risk In Communities Study)

Wesley T. O'Neal, Yi (Grace) Wang, Hau Tieng Wu, Zhu Ming Zhang, Yabing Li, Larisa G. Tereshchenko, E. Harvey Estes, Ingrid Daubechies, Elsayed Z. Soliman

Research output: Contribution to journalArticle

Abstract

The association between the J wave, a key component of the early repolarization pattern, and adverse cardiovascular outcomes remains unclear. Inconsistencies have stemmed from the different methods used to measure the J wave. We examined the association between the J wave, detected by an automated method, and adverse cardiovascular outcomes in 14,592 (mean age = 54 ± 5.8 years; 56% women; 26% black) participants from the Atherosclerosis Risk In Communities (ARIC) study. The J wave was detected at baseline (1987 to 1989) and during follow-up study visits (1990 to 1992, 1993 to 1995, and 1996 to 1998) using a fully automated method. Sudden cardiac death, coronary heart disease death, and cardiovascular mortality were ascertained from hospital discharge records, death certificates, and autopsy data through December 31, 2010. A total of 278 participants (1.9%) had evidence of a J wave. Over a median follow-up of 22 years, 4,376 of the participants (30%) died. In a multivariable Cox regression analysis adjusted for demographics, cardiovascular risk factors, and potential confounders, the J wave was not associated with an increased risk of sudden cardiac death (hazard ratio [HR] 0.74, 95% CI 0.36 to 1.50), coronary heart disease death (HR 0.72, 95% CI 0.40 to 1.32), or cardiovascular mortality (HR 1.16, 95% CI 0.87 to 1.56). An interaction was detected for cardiovascular mortality by gender with men (HR 1.54, 95% CI 1.09 to 2.19) having a stronger association than women (HR 0.74, 95% CI 0.43 to 1.25; P-interaction = 0.030). In conclusion, our findings suggest that the J wave is a benign entity that is not associated with an increased risk for sudden cardiac arrest in middle-aged adults in the United States.

Original languageEnglish (US)
Pages (from-to)811-815
Number of pages5
JournalAmerican Journal of Cardiology
Volume118
Issue number6
DOIs
StatePublished - Sep 15 2016

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Sudden Cardiac Death
Atherosclerosis
Coronary Disease
Mortality
Population
Death Certificates
Hospital Records
Autopsy
Regression Analysis
Demography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Electrocardiographic J Wave and Cardiovascular Outcomes in the General Population (from the Atherosclerosis Risk In Communities Study). / O'Neal, Wesley T.; Wang, Yi (Grace); Wu, Hau Tieng; Zhang, Zhu Ming; Li, Yabing; Tereshchenko, Larisa G.; Estes, E. Harvey; Daubechies, Ingrid; Soliman, Elsayed Z.

In: American Journal of Cardiology, Vol. 118, No. 6, 15.09.2016, p. 811-815.

Research output: Contribution to journalArticle

O'Neal, WT, Wang, YG, Wu, HT, Zhang, ZM, Li, Y, Tereshchenko, LG, Estes, EH, Daubechies, I & Soliman, EZ 2016, 'Electrocardiographic J Wave and Cardiovascular Outcomes in the General Population (from the Atherosclerosis Risk In Communities Study)', American Journal of Cardiology, vol. 118, no. 6, pp. 811-815. https://doi.org/10.1016/j.amjcard.2016.06.047
O'Neal, Wesley T. ; Wang, Yi (Grace) ; Wu, Hau Tieng ; Zhang, Zhu Ming ; Li, Yabing ; Tereshchenko, Larisa G. ; Estes, E. Harvey ; Daubechies, Ingrid ; Soliman, Elsayed Z. / Electrocardiographic J Wave and Cardiovascular Outcomes in the General Population (from the Atherosclerosis Risk In Communities Study). In: American Journal of Cardiology. 2016 ; Vol. 118, No. 6. pp. 811-815.
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abstract = "The association between the J wave, a key component of the early repolarization pattern, and adverse cardiovascular outcomes remains unclear. Inconsistencies have stemmed from the different methods used to measure the J wave. We examined the association between the J wave, detected by an automated method, and adverse cardiovascular outcomes in 14,592 (mean age = 54 ± 5.8 years; 56{\%} women; 26{\%} black) participants from the Atherosclerosis Risk In Communities (ARIC) study. The J wave was detected at baseline (1987 to 1989) and during follow-up study visits (1990 to 1992, 1993 to 1995, and 1996 to 1998) using a fully automated method. Sudden cardiac death, coronary heart disease death, and cardiovascular mortality were ascertained from hospital discharge records, death certificates, and autopsy data through December 31, 2010. A total of 278 participants (1.9{\%}) had evidence of a J wave. Over a median follow-up of 22 years, 4,376 of the participants (30{\%}) died. In a multivariable Cox regression analysis adjusted for demographics, cardiovascular risk factors, and potential confounders, the J wave was not associated with an increased risk of sudden cardiac death (hazard ratio [HR] 0.74, 95{\%} CI 0.36 to 1.50), coronary heart disease death (HR 0.72, 95{\%} CI 0.40 to 1.32), or cardiovascular mortality (HR 1.16, 95{\%} CI 0.87 to 1.56). An interaction was detected for cardiovascular mortality by gender with men (HR 1.54, 95{\%} CI 1.09 to 2.19) having a stronger association than women (HR 0.74, 95{\%} CI 0.43 to 1.25; P-interaction = 0.030). In conclusion, our findings suggest that the J wave is a benign entity that is not associated with an increased risk for sudden cardiac arrest in middle-aged adults in the United States.",
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AU - Zhang, Zhu Ming

AU - Li, Yabing

AU - Tereshchenko, Larisa G.

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