title: An observational study on the effect of premature ventricular complex burden on long-term outcome.
abstract: The long-term clinical impact of premature ventricular complexes (PVCs) on mortality and morbidity has not been fully studied. This study aimed to investigate the association between the burden of PVCs and adverse clinical outcome.A total of 5778 subjects, who were pacemaker-free and ventricular tachycardia-free at baseline, received 24-hour electrocardiography monitoring between January 1, 2002 and December 31, 2004. Clinical event data were retrieved from the Bureau of National Health Insurance of Taiwan. Multivariate Cox hazards regression models and propensity-score matching were applied to assess the association between PVCs and adverse clinical outcome.Average follow-up time was 10[REPLACEMENT CHARACTER]± 1 year. In all, 1403 subjects expired, 1301 subjects were hospitalized in the cardiovascular (CV) ward, 3384 were hospitalized for any reason, and 631 subjects developed new-onset heart failure (HF). The optimal cut-off PVC frequency (12 beats per day) was obtained through receiver operator characteristic curves, with a sensitivity of 58.4% and specificity of 59.8%. Upon multivariate analysis, a PVC frequency >12 beats per day was an independent predictor for all mortality (hazard ratio [HR]: 1.429, 95% confidence interval [CI]: 1.284-1.590), CV hospitalization (HR: 1.127, 95% CI: 1.008-1.260), all-cause hospitalization (HR 1.094, 95% CI: 1.021-1.173), and new-onset HF (HR: 1.411, 95% CI: 1.203-1.655). Subjects with a PVC frequency >12 beats per day had an increased risk of cardiac death attributable to HF and sudden cardiac death. The incidence rates for mortality and HF were significantly increased in cases of raised PVC frequency. Propensity-score matching analysis also echoed the main findings.Increased PVC burden was associated with a higher incidence of all-cause mortality, CV hospitalization, all-cause hospitalization, and new-onset HF which was independent of other clinical risk factors.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital Department of Medicine, Division of Cardiology, National Yang-Ming University School of Medicine, Taipei Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei Division of Cardiology, National Yang-Ming University Hospital, Yi-Lan, Taiwan.
authors.forename: Chin-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Yun-Yu
authors.initials: YY
authors.lastname: Chen
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Fa-Po
authors.initials: FP
authors.lastname: Chung
authors.forename: Jo-Nan
authors.initials: JN
authors.lastname: Liao
authors.forename: Yao-Ting
authors.initials: YT
authors.lastname: Chang
authors.forename: Chung-Hsing
authors.initials: CH
authors.lastname: Lin
authors.forename: Rohit
authors.initials: R
authors.lastname: Walia
authors.forename: Abigail Louise D
authors.initials: ALD
authors.lastname: Te
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamada
authors.forename: Chuen-Wang
authors.initials: CW
authors.lastname: Chiou
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000401:mortality / Q000628:therapy