Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community
JournalJournal of the American Heart Association
PublisherJohn Wiley and Sons Inc.
MetadataShow full item record
AbstractBackground--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. Methods and Results--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. Conclusions--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. Copyright 2017 The Authors and Medtronic.
SponsorsThis work was made possible by the Joseph Drown Foundation (Marcus), R25MD00683, the National Institute on Minority Health and Health Disparities (Nguyen), and grant 16EIA26410001 from the American Heart Association (Alonso). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Grants and contracts for the Cardiovascular Health Study include: contracts HHSN268201200036C, HHSN268200800007C, N01HC 55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086.
Premature atrial contractions
Premature ventricular contractions
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85030694207&doi=10.1161%2fJAHA.117.006028&partnerID=40&md5=1e17b9cd4479f8f1599f757761c06dc2; http://hdl.handle.net/10713/10051