Abstract 16972: Premature Ventricular Complex Characteristics Are Associated With Sudden Cardiac Death: the Atherosclerosis Risk in Communities (ARIC) Study and the Cardiovascular Health Study (CHS)
Introduction: The prognostic impact of premature ventricular complexes (PVCs) is debated, and features of PVCs which associated with risk for sudden cardiac death (SCD) remain poorly described.
Hypothesis: PVC characteristics on resting 12-lead ECG may be associated with SCD in the general adult population.
Methods: Baseline ECGs from the Atherosclerosis Risk in Communities (ARIC) study (N = 14,708) and the Cardiovascular Health Study (CHS, N = 5,580) were reviewed, and PVCs were identified as outflow-tract (OT) or non-outflow tract (NOT) by standard criteria. Prematurity index (PI) was defined as coupling interval (CI) divided by mean sinus-beat RR interval. Adjudicated SCD was the primary outcome. All Cox regression models adjusted for age, race, sex, cohort, and study center. Further adjustment included clinical covariates (prevalent cardiovascular disease and cardiovascular disease risk factors) and ECG covariates (heart rate, QRS duration, QTc, and Cornell product).
Results: In the combined cohort (N = 20,244) there were 489 cases of SCD over a median of 14 years of follow-up. PVCs were present for 555 subjects, and 153 of these had only OT-type PVCs. CI was measurable in 458 cases: mean CI was 559 ± 114 ms, and mean PI was 0.64 ± 0.12. After full adjustment the presence of any PVC was significantly associated with incident SCD (HR 1.72, 95% CI 1.22 - 2.42; p = 0.002), and this held true for both OT-PVCs (HR 2.21, 95% CI 1.14 - 4.28; p = 0.019) and NOT-PVCs (HR 1.60, 95% CI 1.08 - 2.37; p = 0.019). CI (not shown) and PI (see table) demonstrated a significant threshold-effect relationship with SCD.
Conclusions: In two large community-based cohorts, both OT and NOT-PVCs on a baseline 12-lead ECG were independently associated with SCD. CI and PI were also independently associated with SCD. These findings may aid in the future development of SCD risk prediction models.
Author Disclosures: D.M. German: None. M.M. Kabir: None. J. Thomas: None. J.W. Waks: None. C.M. Sitlani: None. M.L. Biggs: None. N. Sotoodehnia: None. D.S. Siscovick: None. E.Z. Soliman: None. C.A. Henrickson: None. T. Biering-Sorensen: None. S.D. Solomon: None. W.S. Post: None. A.E. Buxton: None. M.E. Josephson: None. L.G. Tereshchenko: None.
- © 2016 by American Heart Association, Inc.