Prognostic impact of supraventricular premature complexes in community- based health checkups: The Ibaraki Prefectural Health Study
Prognostic impact of supraventricular premature complexes in community- based health checkups: The Ibaraki Prefectural Health Study
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DOI：
10.1093/eurheartj/ehu407
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发表时间：
2015-01-14
影响因子：
39.3
通讯作者：
Aonuma, Kazutaka
中科院分区：
文献类型：
--
作者：
Murakoshi, Nobuyuki;Xu, DongZhu;Aonuma, Kazutaka
目的在普通人群中，室上性早搏患者的长期预后尚不清楚。方法与结果我们评估了1993年参加年度社区健康体检的63197人(平均年龄58.8+/-9.9岁；女性占67.6%)，并跟踪调查至2008年。在14年的平均随访中，主要终点是中风死亡、心血管死亡(CVD)或全因死亡，次要终点是基线时没有自我报告心脏病或房颤的受试者的第一个心房颤动(AF)事件。与无SVPC的受试者相比，SVPC受试者卒中死亡、心血管疾病和全因死亡的多因素调整危险比[95%可信区间]男性为1.24(0.98~1.56)，女性为1.63(1.30~2.05)，男性为1.22(1.04~1.44)，女性为1.48(1.25~1.74)，男性为1.08(0.99~1.18)，女性为1.21(1.09~1.34)。分别进行了分析。386例受试者在随访期间发生了心房颤动(1.05/1000人年)。基线时SVPC的存在是房颤发病的显著预测因子[HRs(95%CI)：男性4.87(3.61-6.57)，女性3.87(2.69-5.57)]。倾向评分匹配分析还显示，即使在调整潜在混杂因素后，SVPC的存在也与房颤发生率和心血管疾病风险的增加显著相关。结论12导联心电图中SVPC的存在是房颤发生的有力预测因素，并与普通人群心血管疾病风险的增加相关。
Aims The long-term prognosis of subjects with supraventricular premature complexes (SVPCs) remains unclear in the general population. The aim of this study was to examine the prognostic significance of SVPCs in community-based health checkups.Methods and results We assessed 63 197 individuals (mean age, 58.8 +/- 9.9 years; 67.6% women) who participated in annual community-based health checkups in 1993 and were followed until 2008. The primary endpoint was stroke death, cardiovascular death (CVD), or all-cause death during a 14-year mean follow-up, and the secondary endpoint was first atrial fibrillation (AF) event in subjects without self-reported heart diseases or AF at baseline. Compared with subjects without SVPCs, the multivariate-adjusted hazard ratios (HRs) [95% confidence interval (CI)] of stroke death, CVD, and all-cause death in subjects with SVPCs were 1.24 (0.98-1.56) for men and 1.63 (1.30-2.05) for women, 1.22 (1.04-1.44) for men and 1.48 (1.25-1.74) for women, and 1.08 (0.99-1.18) for men and 1.21 (1.09-1.34) for women, respectively. Atrial fibrillation occurred in 386 subjects during the follow-up (1.05/1000 person-years). The presence of SVPCs at baseline was the significant predictor of AF onset [HRs (95% CI): 4.87 (3.61-6.57) for men and 3.87 (2.69-5.57) for women]. Propensity score matched analyses also revealed the presence of SVPCs was significantly associated with increased risks of AF incidence and CVD even after adjusting the potential confounders.Conclusion The presence of SVPCs in 12-lead electrocardiograms was a strong predictor of AF development, and associated with increased risk of CVD in general population.