TY - JOUR
T1 - 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)
AU - Cheriyath, Pramil
AU - He, Fan
AU - Peters, Ian
AU - Li, Xian
AU - Alagona, Peter
AU - Wu, Chuntao
AU - Pu, Min
AU - Cascio, Wayne E.
AU - Liao, Duanping
N1 - Funding Information:
We used public-use data from the Atherosclerosis Risk in Communities (ARIC) study, an ongoing prospective study of the cause and natural history of atherosclerosis funded by the National Heart, Lung, and Blood Institute (NHLBI). Four communities took part in the investigation: Forsyth County, North Carolina; Jackson, Mississippi; suburban Minneapolis, Minnesota; and Washington County, Maryland. The total population of the study, conducted from 1987 to 1989, was 15,732 subjects 45 to 64 years of age at their baseline examination. The ARIC study participants underwent follow-up clinical examinations every 3 years and were contacted by telephone annually to ascertain their general health and any hospitalization events. This report was based on baseline examination and follow-up data on clinical cardiac events up to December 2002, with >14 years of follow-up of ARIC study participants.
PY - 2011/1/15
Y1 - 2011/1/15
N2 - 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.
AB - 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.
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U2 - 10.1016/j.amjcard.2010.09.002
DO - 10.1016/j.amjcard.2010.09.002
M3 - Article
C2 - 21211594
AN - SCOPUS:78650860316
SN - 0002-9149
VL - 107
SP - 151
EP - 155
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 2
ER -