{"doi":"10.1016/j.jacadv.2025.102102","title":"Prevalence and Outcomes of Competitive Athletes From the United States With Electrocardiographic Athletic Anterior Early Repolarization","abstract":"BACKGROUND: ) is considered a normal electrocardiographic (ECG) finding for athletes who self-identify as Black. To date, data defining the prevalence and clinical outcomes of this ECG pattern among non-Black athletes are limited. OBJECTIVES: The authors sought to determine the prevalence and outcomes of anterior early repolarization with T-wave inversions in a diverse, multicenter, and multisport cohort of U.S. competitive athletes. METHODS: In a retrospective analysis of screening athletic ECGs (1993-2025) obtained across four U.S. clinical sites, the prevalence of the athletic anterior early repolarization pattern (ERP) and clinical outcomes were determined. RESULTS: A total of 6,177 ECGs (1,203 [19.5%] Black athletes and 4,974 [80.5%] non-Black athletes; age range: 15 to 25 years) were reviewed. Of these, 47 athletes demonstrated athletic anterior ERP (prevalence = 0.76% [95% CI: 0.50% to 1.01%]); 23 athletes self-identified as Black (prevalence = 1.91% [95% CI: 1.21% to 2.87%]) and 24 as non-Black (prevalence = 0.48% [95% CI: 0.31% to 0.72%]). Among non-Black athletes, the racial and/or ethnic distribution was White (N = 12, 50%), Asian (N = 5, 20%), Hispanic (N = 5, 20%), Asian and White (N = 1, 4%), and Middle-Eastern (N = 1, 4%). Athletic anterior ERP was more common in sports with higher endurance and strength demands. Over 177 athlete-years of follow-up, there were no adverse cardiovascular events. Among non-Black athletes who proceeded with cardiac imaging (N = 18/24, 75%), no structural cardiac pathology or cardiomyopathy was reported. CONCLUSIONS: Athletic anterior ERP appears to be a benign finding irrespective of racial and/or ethnic constructs. Race-based terminology for competitive athletes with this ECG pattern should be avoided.","journal":"JACC Advances","year":2025,"id":532834,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9506,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1414835,"name":"Paishiun Nelson Hsieh","orcid":null,"position":1,"is_corresponding":false},{"id":1164303,"name":"Parth Patel","orcid":"0000-0001-5207-2776","position":2,"is_corresponding":false},{"id":1414344,"name":"Melroy A. D’Souza","orcid":"0000-0002-6798-8960","position":3,"is_corresponding":false},{"id":1414836,"name":"Neeya Patel","orcid":null,"position":4,"is_corresponding":false},{"id":1414837,"name":"Sanchitha Rajesh","orcid":null,"position":5,"is_corresponding":false},{"id":1133617,"name":"Sophia Wolmer","orcid":null,"position":6,"is_corresponding":false},{"id":1414838,"name":"Heather DiGregorio","orcid":null,"position":7,"is_corresponding":false},{"id":1313067,"name":"Rayan El Chami","orcid":null,"position":8,"is_corresponding":false},{"id":1112595,"name":"Mekensie Jackson","orcid":"0009-0008-1217-7037","position":9,"is_corresponding":false},{"id":1385063,"name":"James Miller","orcid":"0000-0001-9518-6060","position":10,"is_corresponding":false},{"id":1414839,"name":"Zain Zaidi","orcid":null,"position":11,"is_corresponding":false},{"id":344676,"name":"Yi-An Ko","orcid":"0000-0002-0066-358X","position":12,"is_corresponding":false},{"id":734021,"name":"Eugene H. Chung","orcid":"0000-0002-7514-627X","position":13,"is_corresponding":false},{"id":316988,"name":"Timothy W. Churchill","orcid":"0000-0002-0215-3049","position":14,"is_corresponding":false},{"id":1414345,"name":"Eli A. Friedman","orcid":"0000-0002-8677-3826","position":15,"is_corresponding":false},{"id":481021,"name":"J. Sawalla Guseh","orcid":"0000-0003-0992-5635","position":16,"is_corresponding":false},{"id":1237546,"name":"Matthew W. Martinez","orcid":"0000-0001-9255-4657","position":17,"is_corresponding":false},{"id":255090,"name":"Aaron L. Baggish","orcid":"0000-0003-2042-1489","position":18,"is_corresponding":false},{"id":264229,"name":"Jonathan H. Kim","orcid":"0000-0001-5885-0284","position":19,"is_corresponding":false},{"id":1313066,"name":"Austin Rim","orcid":null,"position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:51:27.893975Z","pmid":"40857824","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}