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Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community.
Wednesday,2017-10-25 14:49 America/Los_Angeles — ecterry
| Title | Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Nguyen, KT, Vittinghoff, E, Dewland, TA, Dukes, JW, Soliman, EZ, Stein, PK, Gottdiener, JS, Alonso, A, Chen, LY, Psaty, BM, Heckbert, SR, Marcus, GM |
| Journal | J Am Heart Assoc |
| Volume | 6 |
| Issue | 8 |
| Date Published | 2017 Aug 03 |
| ISSN | 2047-9980 |
| Abstract | <p><b>BACKGROUND: </b>Atrial fibrillation and heart failure are 2 of the most common diseases, yet ready means to identify individuals at risk are lacking. The 12-lead ECG is one of the most accessible tests in medicine. Our objective was to determine whether a premature atrial contraction observed on a standard 12-lead ECG would predict atrial fibrillation and mortality and whether a premature ventricular contraction would predict heart failure and mortality.</p><p><b>METHODS AND RESULTS: </b>We utilized the CHS (Cardiovascular Health) Study, which followed 5577 participants for a median of 12 years, as the primary cohort. The ARIC (Atherosclerosis Risk in Communities Study), the replication cohort, captured data from 15 792 participants over a median of 22 years. In the CHS, multivariable analyses revealed that a baseline 12-lead ECG premature atrial contraction predicted a 60% increased risk of atrial fibrillation (hazard ratio, 1.6; 95% CI, 1.3-2.0; P<0.001) and a premature ventricular contraction predicted a 30% increased risk of heart failure (hazard ratio, 1.3; 95% CI, 1.0-1.6; P=0.021). In the negative control analyses, neither predicted incident myocardial infarction. A premature atrial contraction was associated with a 30% increased risk of death (hazard ratio, 1.3; 95% CI, 1.1-1.5; P=0.008) and a premature ventricular contraction was associated with a 20% increased risk of death (hazard ratio, 1.2; 95% CI, 1.0-1.3; P=0.044). Similarly statistically significant results for each analysis were also observed in ARIC.</p><p><b>CONCLUSIONS: </b>Based on a single standard ECG, a premature atrial contraction predicted incident atrial fibrillation and death and a premature ventricular contraction predicted incident heart failure and death, suggesting that this commonly used test may predict future disease.</p> |
| DOI | 10.1161/JAHA.117.006028 |
| Alternate Journal | J Am Heart Assoc |
| PubMed ID | 28775064 |
| PubMed Central ID | PMC5586444 |
ePub date:
17/08