Relation of Atrial and/or Ventricular Premature Complexes on a Two-Minute Rhythm Strip to the Risk of Sudden Cardiac Death (the Atherosclerosis Risk in Communities [ARIC] Study)

被引:56
作者
Cheriyath, Pramil [1 ]
He, Fan [2 ]
Peters, Ian [3 ]
Li, Xian [2 ]
Alagona, Peter, Jr. [4 ,5 ]
Wu, Chuntao [2 ]
Pu, Min [6 ]
Cascio, Wayne E. [7 ,8 ]
Liao, Duanping [2 ]
机构
[1] Harrisburg Hosp, Dept Internal Med, Harrisburg, PA USA
[2] Penn State Univ, Dept Publ Hlth Sci, Coll Med, Hershey, PA USA
[3] Philadelphia Coll Osteopath Med, Philadelphia, PA USA
[4] Penn State Univ, Coll Med, Dept Med, Hershey, PA USA
[5] Penn State Univ, Coll Med, Penn State Heart & Vasc Inst, Hershey, PA USA
[6] Wake Forest Univ, Dept Med, Div Cardiol, Sch Med, Winston Salem, NC 27109 USA
[7] E Carolina Univ, Dept Cardiovasc Sci, Brody Sch Med, Greenville, NC USA
[8] E Carolina Univ, E Carolina Heart Inst, Greenville, NC USA
关键词
CORONARY-HEART-DISEASE; MEN; CONTRACTIONS; SUPPRESSION; POPULATION; MORTALITY; ECTOPY;
D O I
10.1016/j.amjcard.2010.09.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Ventricular premature complexes (VPCs) and atrial premature complexes (APCs) are common findings on routinely obtained electrocardiograms. Despite their common occurrence, the significance of these irregular beats is, unclear, especially with regard to risk of sudden cardiac death (SCD). In this study, we examined the prospective relation between baseline VPCs or APCs and SCD, myocardial infarction, and fatal coronary heart disease (CHD) in a population-based sample of subjects from the Atherosclerosis Risk in Communities (ARIC) study excluding participants with known history of CHD or stroke. Baseline examination was conducted from 1987 to 1989, with follow-up data regarding clinical cardiac events collected until December 2002. The total study population was 14,574 subjects. Kaplan-Meier curves and computed univariate and multivariate Cox proportional hazard models were employed to estimate the effect of VPC and APC occurrences on incident cardiac events. During the follow-up period, there were 130 incident cases of SCD, 1,657 incident cases of CHD cases, and 288 cases of fatal CHD. Participants with VPC were 2 times as likely to have SCD (hazard ratio [HR] 2.09, 95% confidence interval [CI] 1.22 to 3.56) compared to those without VPC. Presence of APC was not significantly associated with SCD (HR 1.15, 95% CI 0.56 to 2.39). Compared to subjects without VPC and APC, risk of SCD in subjects with VPC and APC was significantly increased (HR 6.39, 95% CI 2.58 to 15.84). In conclusion, our study shows that subjects with VPCs are significantly more likely to die from SCD, despite not having any known history of cardiovascular disease. This effect appears to be additive when APCs occur concurrently. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:151-155)
引用
收藏
页码:151 / 155
页数:5
相关论文
共 16 条
[1]   RELATION BETWEEN VENTRICULAR PREMATURE COMPLEXES AND SUDDEN CARDIAC DEATH IN APPARENTLY HEALTHY-MEN [J].
ABDALLA, ISH ;
PRINEAS, RJ ;
NEATON, JD ;
JACOBS, DR ;
CROW, RS .
AMERICAN JOURNAL OF CARDIOLOGY, 1987, 60 (13) :1036-1042
[2]   THE RHYTHM OF THE HEART IN ACTIVE ELDERLY SUBJECTS [J].
CAMM, AJ ;
EVANS, KE ;
WARD, DE ;
MARTIN, A .
AMERICAN HEART JOURNAL, 1980, 99 (05) :598-603
[3]  
Chugh S, 2008, J AM COLL CARDIOL, V51, pB94
[4]   VENTRICULAR PREMATURE BEATS - SCREENING AND INDUCTION TESTS IN NORMAL MEN [J].
DEBACKER, G ;
JACOBS, DR ;
PRINEAS, RJ ;
CROW, RS ;
KENNEDY, H ;
VILANDRE, J ;
BLACKBURN, H .
CARDIOLOGY, 1980, 65 (01) :23-41
[5]   MORTALITY AND MORBIDITY IN PATIENTS RECEIVING ENCAINIDE, FLECAINIDE, OR PLACEBO - THE CARDIAC-ARRHYTHMIA SUPPRESSION TRIAL [J].
ECHT, DS ;
LIEBSON, PR ;
MITCHELL, LB ;
PETERS, RW ;
OBIASMANNO, D ;
BARKER, AH ;
ARENSBERG, D ;
BAKER, A ;
FRIEDMAN, L ;
GREENE, HL ;
HUTHER, ML ;
RICHARDSON, DW .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (12) :781-788
[6]   Validation of a short rhythm strip compared to ambulatory ECG monitoring for ventricular ectopy [J].
Evenson, KR ;
Welch, VLL ;
Cascio, WE ;
Simpson, RJ .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2000, 53 (05) :491-497
[7]   CARDIAC-ARRHYTHMIAS IN A HEALTHY ELDERLY POPULATION - DETECTION BY 24-HOUR AMBULATORY ELECTROCARDIOGRAPHY [J].
FLEG, JL ;
KENNEDY, HL .
CHEST, 1982, 81 (03) :302-307
[8]  
Folarin VA, 2001, AVIAT SPACE ENVIR MD, V72, P836
[9]   SUPPRESSION OF PREMATURE VENTRICULAR CONTRACTIONS BY ACEBUTOLOL [J].
GRADMAN, AH ;
WINKLE, RA ;
FITZGERALD, JW ;
MEFFIN, PJ ;
STONER, J ;
BELL, PA ;
HARRISON, DC .
CIRCULATION, 1977, 55 (05) :785-791
[10]   LONG-TERM FOLLOW-UP OF ASYMPTOMATIC HEALTHY-SUBJECTS WITH FREQUENT AND COMPLEX VENTRICULAR ECTOPY [J].
KENNEDY, HL ;
WHITLOCK, JA ;
SPRAGUE, MK ;
KENNEDY, LJ ;
BUCKINGHAM, TA ;
GOLDBERG, RJ .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 312 (04) :193-197