EU-funded researchers in Germany have discovered that unexpectedly high numbers of people in the 35 to 54 age group show an early repolarisation pattern (ERP) on their electrocardiogram (ECG). Furthermore, people with ERP, especially men, appear to be at a higher risk of cardiac death. ECGs pick up the tiny electrical waves generated by the beating heart via electrodes on the skin and so provide information about the health of a heart. ERP is a type of wave pattern that is often seen on ECGs, and previous studies have suggested that it may be associated with a raised risk of cardiac death. Presented in the journal Public Library of Science (PLoS) Medicine, the study's results are part of the CARDIOGENICS ('Identification of genetic roots of coronary artery disease by combining stepwise genome-wide association studies with transcriptomic and functional genomic investigation of relevant genetic variants') project, funded to the tune of EUR 10 million under the 'Life sciences, genomics and biotechnology for health' Thematic area of the EU's Sixth Framework Programme (FP6). Cardiovascular diseases are the leading cause of mortality in the developed world. Around 50% of these cases are triggered by cardiac arrest (i.e. blood is not pumped to the heart), and death follows within minutes in 95% of cases. Cardiopulmonary resuscitation (CPR) can support a patient until medical experts can use a defibrillator to restore their heartbeat. Along with his colleagues, Professor Stefan Kääb of University Hospital Munich at Ludwig-Maximilians University Munich in Germany launched an investigation to determine the prevalence of ERP and its relationship with cardiac death. The team also assessed mortality triggered by any cause in the World Health Organization (WHO)-backed MONICA ('Monitoring of trends and determinants in cardiovascular disease') study, which evaluated cardiovascular disease in 10 million people in 21 nations. The KORA study represented data amassed in the German region of Augsburg. This latest study offers the medical world fresh insight into the connection between ERP and cardiac death. Professor Kääb and his team chose 1,945 MONICA/KORA participants aged between 35 and 54 years and studied their ECGs. Based on their investigation, ERP was identified in 13.1% of the cases. The researchers also found that people with ERP aged 35-54 years had twice the risk of succumbing to cardiac death, while the risk figure was 2.65-fold stronger for men. The results also showed that the risk of cardiac death with an ERP localised to the bottom of the heart (inferior localisation) triples among men and women in this age group, and quadruples for men alone. In addition, the team found that ERP has a strong connection with a higher risk of all-cause mortality but a lesser one with cardiac death. Coordinated by the Universität zu Lübeck in Germany, CARDIOGENICS is investigating and exploiting state of the art in genomics to identify risk genes for coronary artery disease (CAD) and myocardial infarction (MI). Scheduled to end in September 2010, CARDIOGENICS brings together experts from Canada, France, Germany, Italy, the Netherlands, Sweden and the UK. The results are also connected to the MONICA/KORA study, focusing on middle-aged people of central European descent.