The Relevant Study Of Early Repolarization On The Development And Prognosis Of Ventricular Arrhythmia In STEMI Patients

Objective: To investigate the effects of Early Repolarization(ER)on Ventricular Arrhythmia(VA)during hospitalization and long-term prognosis in patients with acute ST-elevation elevation myocardial infarction(STEMI).Methods: The clinical bseline datas and electrocardiographic datas of 298 STEMI patients were retrospectively analyzed.The baseline datas were compared between the two groups according to whether the early repolarization was divided into ER group and No ER group,Including 56 subjects of ER group,242 subjects without ER group.The occurrencing of VA risk factors were analyzed by univariate and multivariate Logistic regression during hospitalization.The ER group were divided into the notching ER group and the sluring ER group according to the ER morphology,were divided into the inferior ER group and no-inferior ER group according to distribution the leads,were divided into horizontal/downsloping ST segments group and upsloping ST-segment group according to the form of ST segment,the incidence of ventricular arrhythmia and long term all cause mortality respectively were compared with the No ER group.Results: 1.There was no significant difference in baseline data between ER group and No ER group;ER group on the incidence of VA during hospitalization and all-cause mortality during follow-up were higher than the No ER group,the difference was statistically significant(P<0.001,P=0.01);ER and LVEF <50% were independent predictors of VA with STEMI patients during hospitalization by multivariate logistic regression analysis.2.There were significant differences between the notching ER group,the sluring ER group and the No ER group on incidence of VA during hospitalization and the all-cause mortality during the follow-up(p<0.001,P=0.02).Comparison of two,there were statistically significant differences between notching ER group and No ER group on the incidence of VA during hospitalization and the all-cause mortality during the follow-up(p<0.001,p=0.004),the other groups were not statistically significant.There were significant differences between the inferior ER group,the non-inferior ER group and the No ER group on the incidence of VA during the hospitalization and all-cause mortality during the follow-up(P<0.001,P=0.038).Comparison of two,there were statistically significant differences between the inferior ER group and the No ER group on the incidence of VA during hospitalization(P<0.001),and the other groups differences were not statistically significant.There were significant differences between horizontal/downsloping ST segments group,upsloping ST-segment group and No ER group on the incidence of VA during hospitalization and the all-cause mortality during follow-up(P<0.001,P=0.003).Comparison of two,the difference was statistically significant between horizontal/downsloping ST segments group and No ER group on the incidence of VA during hospitalization and the all-cause mortality during follow-up(P<0.001,P=0.01),and there were no significant difference between the other groups.Conclusions: Early repolarization,especially the notching ER and horizontal /downsloping ST segments increased the incidence of VA during hospitalization and the all-cause mortality during follow-up in patients with STEMI.Inferior ER increasesd the incidence of VA during hospitalization,ER and LVEF <50% were independent risk of incidence of VA during hospitalization in patients with STEMI.