RELATION BETWEEN VENTRICULAR PREMATURE COMPLEXES AND SUDDEN CARDIAC DEATH IN APPARENTLY HEALTHY-MEN
RELATION BETWEEN VENTRICULAR PREMATURE COMPLEXES AND SUDDEN CARDIAC DEATH IN APPARENTLY HEALTHY-MEN
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DOI：
10.1016/0002-9149(87)90348-1
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发表时间：
1987-11-01
影响因子：
2.8
通讯作者：
CROW, RS
中科院分区：
文献类型：
--
作者：
ABDALLA, ISH;PRINEAS, RJ;CROW, RS
在一项前瞻性研究中，对15，637名年龄在35至57岁、表面健康的白色男性进行了评价，以评价静息2分钟导联I心电图节律条检测到的室性早搏（VPC）与症状发作1小时内发生的心源性猝死（SCD）之间的相关性。在第一次筛选检查（1973年至1975年），以确定是否有资格参加明尼苏达州明尼阿波利斯/圣保罗的多风险因素干预试验。任何VPC的患病率为4.4%（681/15，637）。在平均7.5年的随访期内，共发生381例死亡。其中，34%（131/381）归因于冠状动脉疾病（CAD），31%的CAD死亡（41/131）突然发生。任何VPC的存在与SCD的显著高风险相关（校正的相对风险= 3.0 p < 0.025）。另一方面，任何VPC的存在与非SCD或CAD总死亡风险的任何显著增加无关（校正的相对风险分别为1.0和1.6）。当VPC特征如频率（每2分钟2个或更多统一VPC）和复杂性（多形式、成对、运行、R-onT）进行了检查，频繁或复杂VPC的患者SCD风险显著增加。（校正的相对危险度= 4.2; p < 0.005），而对于非SCD，未发现危险度的显著增加（校正的相对危险度= 1.6; p = 0.28）。这些数据还表明，50岁以下男性中频繁/复杂VPC的存在比50岁或以上的男性发生SCD的风险更大。VPC对SCD的特异性可能与病因相关，值得对短期心电图记录显示VPC（特别是频繁/复杂）的健康男性进行仔细评估。
The association between ventricular premature complexes (VPCs) detected on a rest 2-minutes lead I electrocardiographic rhythm strip and sudden cardiac death (SCD), occurring within 1 hour of onset of symptoms, was evaluated in a prospective study of 15,637 apparently healthy white men, aged 35 to 57 years, at the first screening examination (1973 to 1975) to determine eligibility for the Multiple Risk Factor intervention Trial in Minneapolis/St. Paul, Minnesota. The prevalence of any VPC was 4.4% (681 of 15,637). Over an average follow-up period of 7.5 years, a total of 381 deaths occurred. Of these, 34% (131 of 381) were ascribed to coronary artery disease (CAD) and 31% of the CAD deaths (41 of 131) occurred suddenly. The presence of any VPC was associated with a significantly higher risk for SCD (adjusted relative risk = 3.0 p < 0.025). On the other hand, the presence of any VPC was not associated with any significant increase in the risk of non-SCD or of total deaths from CAD (adjusted relative risks = 1.0 and 1.6, respectively). When VPC characteristics such as frequency (2 or more uniform VPCs every 2 minutes) and complexity (multiforms, pairs, runs, R-onT) were examined, those with frequent or complex VPCs were at a significantly increased risk of SCD (adjusted relative risk = 4.2; p < 0.005), whereas for non-SCD no significant increase in risk was found (adjusted relative risk = 1.6; p = 0.28). The data also suggest that the presence of frequent/complex VPCs carries a greater risk for SCD in men younger than 50 years of age than in those 50 years or older. The specificity of VPCs to SCD may bear an etiologic association and merits a careful evaluation of otherwise healthy men who demonstrate VPCs, particularly frequent/complex, on a short-term electrocardiographic recording.