Abstract 1328: Premature Cardiac Contractions and Risk of Incident Ischemic Stroke
Title: Association between premature atrial and ventricular contractions and risk of incident ischemic stroke
Objectives: To evaluate the longitudinal relationship between premature atrial (PAC) and ventricular (PVC) contractions and ischemic stroke in a general population-based sample.
Methods: Design: Prospective Longitudinal Study of the Population-based Atherosclerosis Risk in Communities (ARIC) study Subjects: 15,732 Caucasians and African-Americans, 45 to 64 years of age Predictor: Presence of PAC or PVC on baseline 2-minute electrocardiogram (EKG) Outcome: Incident stroke after 13years of follow up Analysis: Cox Proportional Hazard Regression
Results: 15,732 baseline stroke-free participants were included in this analysis. PACs and PVCs were detected by baseline 2-minute EKG in 812 (5%) and 967 (6%) participants, respectively. During the follow-up, 625 (4%) participants developed incident ischemic stroke. Controlling for cardiovascular risk factors and other potential confounders, participants with PACs were equally as likely to develop incident ischemic stroke compared to those without PACs: Adjusted Hazard Ratio 1.22 (95% CI 0.89 –1.69); Participants with PVCs were almost twice as likely to develop incident ischemic stroke: Adjusted Hazard Ratio 1.66 (95% CI 1.06 –2.61).
Conclusions: Presence of premature ventricular contractions may represent an independent risk factor for ischemic stroke. The risk of ischemic stroke arising from presence of premature atrial contractions is not statistically significant. The effects of both PAC and PVC may actually be greater than observed in this study due to the potential of systematic underdiagnosis of these conditions based purely on 2-minute EKG.