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

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31 Citations (Scopus)


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 ≥0.1 mV 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.

Original languageEnglish
Pages (from-to)1260-1266
Number of pages7
JournalCirculation Journal
Issue number5
Publication statusPublished - 2013


  • Cardiovascular diseases
  • Coronary artery disease
  • Electrocardiography
  • Epidemiology
  • J-point

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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