title: Usefulness of ventricular premature complexes to predict coronary heart disease events and mortality (from the Atherosclerosis Risk In Communities cohort).
abstract: The clinical relevance of ventricular premature complexes (VPCs) in apparently healthy patients is not clear and is typically not considered when evaluating risk. We conducted a prospective longitudinal study of the population-based Atherosclerosis Risk In Communities (ARIC) study of 15,070 Caucasians and African-Americans, 45 to 64 years of age, to assess the risks of coronary heart disease (CHD) events and mortality associated with VPCs among participants with and without prevalent CHD at baseline. VPCs on a single 2-minute electrocardiogram were identified in 940 participants (6.2%). After a follow-up of >10 years, 1,762 participants died, with 366 deaths related to CHD, and 1,736 had cardiac events. The percentage of participants with CHD mortality was >3 times greater for those with VPCs compared with those without VPCs. After controlling for cardiovascular risk factors and therapy with proportional hazards regression, participants with VPCs were >2 times as likely to die due to CHD than were those without VPCs. Increased risk was found for participants with and without baseline CHD. In conclusion, a clinical finding of VPCs on electrocardiography of even apparently healthy patients may warrant a heightened awareness of and attention to cardiovascular risk assessment and management.
authors.affiliation: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Massing
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Simpson
authors.forename: Pentti M
authors.initials: PM
authors.lastname: Rautaharju
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.forename: Richard
authors.initials: R
authors.lastname: Crow
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
mesh_terms: D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D016019:Survival Analysis; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000175:diagnosis