Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community

Kaylin T. Nguyen, Eric Vittinghoff, Thomas Dewland, Jonathan W. Dukes, Elsayed Z. Soliman, Phyllis K. Stein, John S. Gottdiener, Alvaro Alonso, Lin Y. Chen, Bruce M. Psaty, Susan R. Heckbert, Gregory M. Marcus

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background--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.

Original languageEnglish (US)
Article numbere006028
JournalJournal of the American Heart Association
Volume6
Issue number8
DOIs
StatePublished - Aug 1 2017

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Muscular Diseases
Electrocardiography
Atrial Premature Complexes
Ventricular Premature Complexes
Atrial Fibrillation
Heart Failure
Atherosclerosis
Mortality
Lead
Cohort Studies
Myocardial Infarction
Medicine
Health

Keywords

  • Atrial fibrillation
  • Heart failure
  • Mortality
  • Premature atrial contractions
  • Premature ventricular contractions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nguyen, K. T., Vittinghoff, E., Dewland, T., Dukes, J. W., Soliman, E. Z., Stein, P. K., ... Marcus, G. M. (2017). Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community. Journal of the American Heart Association, 6(8), [e006028]. https://doi.org/10.1161/JAHA.117.006028

Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community. / Nguyen, Kaylin T.; Vittinghoff, Eric; Dewland, Thomas; Dukes, Jonathan W.; Soliman, Elsayed Z.; Stein, Phyllis K.; Gottdiener, John S.; Alonso, Alvaro; Chen, Lin Y.; Psaty, Bruce M.; Heckbert, Susan R.; Marcus, Gregory M.

In: Journal of the American Heart Association, Vol. 6, No. 8, e006028, 01.08.2017.

Research output: Contribution to journalArticle

Nguyen, KT, Vittinghoff, E, Dewland, T, Dukes, JW, Soliman, EZ, Stein, PK, Gottdiener, JS, Alonso, A, Chen, LY, Psaty, BM, Heckbert, SR & Marcus, GM 2017, 'Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community', Journal of the American Heart Association, vol. 6, no. 8, e006028. https://doi.org/10.1161/JAHA.117.006028
Nguyen, Kaylin T. ; Vittinghoff, Eric ; Dewland, Thomas ; Dukes, Jonathan W. ; Soliman, Elsayed Z. ; Stein, Phyllis K. ; Gottdiener, John S. ; Alonso, Alvaro ; Chen, Lin Y. ; Psaty, Bruce M. ; Heckbert, Susan R. ; Marcus, Gregory M. / Ectopy on a Single 12-Lead ECG, Incident Cardiac Myopathy, and Death in the Community. In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 8.
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abstract = "Background--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.",
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AU - Dewland, Thomas

AU - Dukes, Jonathan W.

AU - Soliman, Elsayed Z.

AU - Stein, Phyllis K.

AU - Gottdiener, John S.

AU - Alonso, Alvaro

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N2 - Background--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.

AB - Background--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.

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KW - Heart failure

KW - Mortality

KW - Premature atrial contractions

KW - Premature ventricular contractions

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