Aim. We aimed to demonstrate the independent effect of mean arterial pressure (MAP) on incident nonalcoholic fatty liver disease (NAFLD) among the nonobese Chinese with normal low-density lipoprotein cholesterol (LDL-C) levels. Methods. 16,153 nonobese participants without NAFLD at baseline were enrolled and then assigned to four groups by quartiles of MAP (Q1-Q4). A subgroup analysis by gender was also conducted. Participants were diagnosed with NAFLD by ultrasonography. Results. During a mean follow-up of 2.80 years, the cumulative incidence of NAFLD was 14.37 and the incidence rate was 513.17 per 10,000 person-years. The cumulative incidence of NAFLD for the whole population or gender groups gradually increased with the quartiles of MAP (all P<0.001). In the Q4 of MAP, the cumulative incidence of NAFLD for the whole population, male, and female reached up to 6.22 (5.75-6.70), 6.70 (6.21-7.19), and 5.69 (5.24-6.14), respectively. After adjustment for potential confounders, as compared with Q1, the hazard ratio for NAFLD was 1.328 (1.072-1.647), 1.625 (1.276-2.069), and 1.697 (1.231-2.340) for Q2, Q3, and Q4, respectively. In subgroup analysis, the respective hazard ratio for NAFLD in Q2, Q3, and Q4 of MAP was 1.760 (1.276-2.429), 2.080 (1.433-3.019), and 2.377 (1.452-3.890), compared with female in the Q1 of MAP. But MAP was not associated with incident NAFLD in male. Besides, MAP had a larger area under the receiver-operating characteristic curves than SBP or DBP, with optimal cutoff point of 88 mmHg in male and 89 mmHg in female. Conclusions. MAP is an independent predictor for incident NAFLD among nonobese female with normal LDL levels.

Background Recent studies indicated that fragmented QRS (fQRS) is associated with malignant cardiac arrhythmias in patients with acute myocardial infarction (AMI). However, a systematic review and meta‐analysis on this issue still have not been conducted. Thus, we performed a systematic review and meta‐analysis to access the predictive value of fQRS for ventricular tachyarrhythmias (VTAs) in patients with AMI. Materials and Methods We searched the databases of PubMed, Embase and Cochrane Library for relevant studies until 8 June 2019. We included studies which compared VTAs in AMI patients with fQRS vs without fQRS. Results Six studies enrolling 2218 ST‐segment elevation myocardial infarction (STEMI) patients were included in this meta‐analysis. The fQRS was significantly associated with greater risk of VTAs in STEMI patients (Odds ratio [OR] 2.81, 95% confidence interval (CI) 1.99‐3.95, P < .00001; I2 = 30%). This association was still significant both in prospective (OR 3.25, 95% CI 1.94‐5.46, P < .00001; I2 = 0%) and retrospective (OR 2.40, 95% CI 1.22‐4.74, P = .01; I2 = 54%) studies. In particularly, fQRS in patients with low left ventricular ejection fraction (≤50%) (OR 2.97, 95% CI 1.88‐4.70, P < .00001; I2 = 21%) or <60 years old (OR 3.07, 95% CI 2.02‐4.66, P < .00001; I2 = 0%) tripled the risk of VTAs during AMI. Conclusion Our meta‐analysis demonstrated that fQRS increases the risk of developing VTAs in patients with STEMI.

Several studies have indicated that early repolarization (ER) is a risk factor for ventricular tachyarrhythmias (VTAs) in acute myocardial infarction (AMI) patients. The prognostic values of ER detail characteristics except J-point morphology, and inferior leads ER location for VTAs are still unclear. We searched PubMed, Embase, and the Cochrane Library for eligible studies up to March 4, 2019. Studies to investigate the relationship between ER and the incidence of VTAs in AMI patients were extracted. A total of 10 studies with 2,672 participants were included in the analysis. ER significantly predicted the incidence of VTAs (odds ratio [OR] 3.62, 95% confidence intervals [CI] 2.77–4.73), regardless of the type of AMI. The presence of ER before AMI (OR 5.58, 95% CI 3.41 to 9.12) and after AMI (OR 3.02, 95% CI 2.19–4.15) increased the risk of VTAs. The prognostic value of ER for VTAs in the long follow-up (≥30 days) (OR 2.39, 95% CI 1.59–3.59) fell by half compared to the short follow-up duration (<30 days) (OR 4.97, 95% CI 3.48–7.09). Patients with ER displayed a higher risk of developing ventricular fibrillation (VF) (OR 6.94, 95% CI 3.87–12.43) than those without ER. However, neither J-point elevation with OR = 2.48 nor lateral leads’ ER location with OR = 3.83 remarkably increased the risk of VTAs in patients with AMI. ER is significantly associated with increasing risk of VTAs, particularly VF, in AMI patients. This relationship is weaker in the 30-day follow-up and is not reinforced by J-point elevation and lateral leads’ ER location.