title: Premature ventricular complexes on screening electrocardiogram and risk of ischemic stroke.
abstract: OBJECTIVE
  Premature ventricular complexes (PVCs) detected from long-term ECG recordings have been associated with an increased risk of ischemic stroke. Whether PVCs seen on routine ECG, commonly used in clinical practice, are associated with an increased risk of ischemic stroke remains unstudied.
  
  
  METHODS
  This analysis included 24 460 participants (aged, 64.5+9.3 years; 55.1% women; 40.0% blacks) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of stroke at the time of enrollment. PVCs were ascertained from baseline ECG (2003-2007), and incident stroke cases through 2011 were confirmed by an adjudication committee.
  
  
  RESULTS
  A total of 1415 (5.8%) participants had at least 1 PVC at baseline, and 591 developed incident ischemic stroke during an average (SD) follow-up of 6.0 (2.0) years. In a cox proportional hazards model adjusted for age, sex, race, geographic region, education, previous heart disease, systolic blood pressure, blood pressure-lowering medications, current smoking, diabetes mellitus, left ventricular hypertrophy by ECG, and aspirin use and warfarin use, the presence of PVCs was associated with 38% increased risk of ischemic stroke (hazard ratio [95% confidence interval], 1.38 [1.05-1.81]).
  
  
  CONCLUSIONS
  PVCs are common on routine screening ECGs and are associated with an increased risk of ischemic stroke.
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.). sunilagarwal1@gmail.com.
authors: Sunil K
authors: SK
authors: Agarwal
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Jennifer
authors: J
authors: Chao
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Frederick
authors: F
authors: Peace
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Suzanne E
authors: SE
authors: Judd
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Brett
authors: B
authors: Kissela
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Dawn
authors: D
authors: Kleindorfer
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Virginia J
authors: VJ
authors: Howard
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: George
authors: G
authors: Howard
authors: From the Division of Cardiology (S.K.A.) and Department of Internal Medicine (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Biostatistics (F.P., S.E.J., G.H.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincannati, OH (B.K., D.K.); and Division of Epidemiology and Prevention EpiCare, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Elsayed Z
authors: EZ
authors: Soliman
mesh_terms: D000368:Aged; D044383:Black People; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology; D018879:Ventricular Premature Complexes / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D044465:White People
keywords: hypoxia-ischemia, brain; stroke; ventricular premature complexes