An observational study on the effect of premature ventricular complex burden on long-term outcome

Chin Yu Lin, Shih Lin Chang, Yenn Jiang Lin, Yun Yu Chen, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Tze Fan Chao, Fa Po Chung, Jo Nan Liao, Yao Ting Chang, Chung-Hsing Lin, Rohit Walia, Abigail Louise D. Te, Shinya Yamada, Chuen Wang Chiou, Hsuan Ming Tsao, Shih Ann Chen

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The long-term clinical impact of premature ventricular complexes (PVCs) on mortality and morbidity has not been fully studied. This study aimed to investigate the association between the burden of PVCs and adverse clinical outcome. A total of 5778 subjects, who were pacemaker-free and ventricular tachycardia-free at baseline, received 24-hour electrocardiography monitoring between January 1, 2002 and December 31, 2004. Clinical event data were retrieved from the Bureau of National Health Insurance of Taiwan. Multivariate Cox hazards regression models and propensity-score matching were applied to assess the association between PVCs and adverse clinical outcome. Average follow-up time was 10±1 year. In all, 1403 subjects expired, 1301 subjects were hospitalized in the cardiovascular (CV) ward, 3384 were hospitalized for any reason, and 631 subjects developed new-onset heart failure (HF). The optimal cut-off PVC frequency (12 beats per day) was obtained through receiver operator characteristic curves, with a sensitivity of 58.4% and specificity of 59.8%. Upon multivariate analysis, a PVC frequency >12 beats per day was an independent predictor for all mortality (hazard ratio [HR]: 1.429, 95% confidence interval [CI]: 1.284-1.590), CV hospitalization (HR: 1.127, 95% CI: 1.008-1.260), all-cause hospitalization (HR 1.094, 95% CI: 1.021-1.173), and new-onset HF (HR: 1.411, 95% CI: 1.203-1.655). Subjects with a PVC frequency>12 beats per day had an increased risk of cardiac death attributable to HF and sudden cardiac death. The incidence rates for mortality and HF were significantly increased in cases of raised PVC frequency. Propensity-score matching analysis also echoed the main findings. Increased PVC burden was associated with a higher incidence of all-cause mortality, CV hospitalization, all-cause hospitalization, and new-onset HF which was independent of other clinical risk factors.

Original languageEnglish
Article numbere5476
JournalMedicine (United States)
Volume96
Issue number1
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Fingerprint

Ventricular Premature Complexes
Observational Studies
Heart Failure
Hospitalization
Confidence Intervals
Propensity Score
Mortality
Sudden Cardiac Death
Incidence
National Health Programs
Ventricular Tachycardia
Taiwan
Proportional Hazards Models
Electrocardiography
Multivariate Analysis
Morbidity
Sensitivity and Specificity

Keywords

  • Heart failure
  • Mortality
  • Premature ventricular complexes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lin, C. Y., Chang, S. L., Lin, Y. J., Chen, Y. Y., Lo, L. W., Hu, Y. F., ... Chen, S. A. (2017). An observational study on the effect of premature ventricular complex burden on long-term outcome. Medicine (United States), 96(1), [e5476]. https://doi.org/10.1097/MD.0000000000005476

An observational study on the effect of premature ventricular complex burden on long-term outcome. / Lin, Chin Yu; Chang, Shih Lin; Lin, Yenn Jiang; Chen, Yun Yu; Lo, Li Wei; Hu, Yu Feng; Tuan, Ta Chuan; Chao, Tze Fan; Chung, Fa Po; Liao, Jo Nan; Chang, Yao Ting; Lin, Chung-Hsing; Walia, Rohit; Te, Abigail Louise D.; Yamada, Shinya; Chiou, Chuen Wang; Tsao, Hsuan Ming; Chen, Shih Ann.

In: Medicine (United States), Vol. 96, No. 1, e5476, 01.01.2017.

Research output: Contribution to journalArticle

Lin, CY, Chang, SL, Lin, YJ, Chen, YY, Lo, LW, Hu, YF, Tuan, TC, Chao, TF, Chung, FP, Liao, JN, Chang, YT, Lin, C-H, Walia, R, Te, ALD, Yamada, S, Chiou, CW, Tsao, HM & Chen, SA 2017, 'An observational study on the effect of premature ventricular complex burden on long-term outcome', Medicine (United States), vol. 96, no. 1, e5476. https://doi.org/10.1097/MD.0000000000005476
Lin, Chin Yu ; Chang, Shih Lin ; Lin, Yenn Jiang ; Chen, Yun Yu ; Lo, Li Wei ; Hu, Yu Feng ; Tuan, Ta Chuan ; Chao, Tze Fan ; Chung, Fa Po ; Liao, Jo Nan ; Chang, Yao Ting ; Lin, Chung-Hsing ; Walia, Rohit ; Te, Abigail Louise D. ; Yamada, Shinya ; Chiou, Chuen Wang ; Tsao, Hsuan Ming ; Chen, Shih Ann. / An observational study on the effect of premature ventricular complex burden on long-term outcome. In: Medicine (United States). 2017 ; Vol. 96, No. 1.
@article{5eb2f8f812674b2db44185163cc680d1,
title = "An observational study on the effect of premature ventricular complex burden on long-term outcome",
abstract = "The long-term clinical impact of premature ventricular complexes (PVCs) on mortality and morbidity has not been fully studied. This study aimed to investigate the association between the burden of PVCs and adverse clinical outcome. A total of 5778 subjects, who were pacemaker-free and ventricular tachycardia-free at baseline, received 24-hour electrocardiography monitoring between January 1, 2002 and December 31, 2004. Clinical event data were retrieved from the Bureau of National Health Insurance of Taiwan. Multivariate Cox hazards regression models and propensity-score matching were applied to assess the association between PVCs and adverse clinical outcome. Average follow-up time was 10±1 year. In all, 1403 subjects expired, 1301 subjects were hospitalized in the cardiovascular (CV) ward, 3384 were hospitalized for any reason, and 631 subjects developed new-onset heart failure (HF). The optimal cut-off PVC frequency (12 beats per day) was obtained through receiver operator characteristic curves, with a sensitivity of 58.4{\%} and specificity of 59.8{\%}. Upon multivariate analysis, a PVC frequency >12 beats per day was an independent predictor for all mortality (hazard ratio [HR]: 1.429, 95{\%} confidence interval [CI]: 1.284-1.590), CV hospitalization (HR: 1.127, 95{\%} CI: 1.008-1.260), all-cause hospitalization (HR 1.094, 95{\%} CI: 1.021-1.173), and new-onset HF (HR: 1.411, 95{\%} CI: 1.203-1.655). Subjects with a PVC frequency>12 beats per day had an increased risk of cardiac death attributable to HF and sudden cardiac death. The incidence rates for mortality and HF were significantly increased in cases of raised PVC frequency. Propensity-score matching analysis also echoed the main findings. Increased PVC burden was associated with a higher incidence of all-cause mortality, CV hospitalization, all-cause hospitalization, and new-onset HF which was independent of other clinical risk factors.",
keywords = "Heart failure, Mortality, Premature ventricular complexes",
author = "Lin, {Chin Yu} and Chang, {Shih Lin} and Lin, {Yenn Jiang} and Chen, {Yun Yu} and Lo, {Li Wei} and Hu, {Yu Feng} and Tuan, {Ta Chuan} and Chao, {Tze Fan} and Chung, {Fa Po} and Liao, {Jo Nan} and Chang, {Yao Ting} and Chung-Hsing Lin and Rohit Walia and Te, {Abigail Louise D.} and Shinya Yamada and Chiou, {Chuen Wang} and Tsao, {Hsuan Ming} and Chen, {Shih Ann}",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/MD.0000000000005476",
language = "English",
volume = "96",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - An observational study on the effect of premature ventricular complex burden on long-term outcome

AU - Lin, Chin Yu

AU - Chang, Shih Lin

AU - Lin, Yenn Jiang

AU - Chen, Yun Yu

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Tuan, Ta Chuan

AU - Chao, Tze Fan

AU - Chung, Fa Po

AU - Liao, Jo Nan

AU - Chang, Yao Ting

AU - Lin, Chung-Hsing

AU - Walia, Rohit

AU - Te, Abigail Louise D.

AU - Yamada, Shinya

AU - Chiou, Chuen Wang

AU - Tsao, Hsuan Ming

AU - Chen, Shih Ann

PY - 2017/1/1

Y1 - 2017/1/1

N2 - The long-term clinical impact of premature ventricular complexes (PVCs) on mortality and morbidity has not been fully studied. This study aimed to investigate the association between the burden of PVCs and adverse clinical outcome. A total of 5778 subjects, who were pacemaker-free and ventricular tachycardia-free at baseline, received 24-hour electrocardiography monitoring between January 1, 2002 and December 31, 2004. Clinical event data were retrieved from the Bureau of National Health Insurance of Taiwan. Multivariate Cox hazards regression models and propensity-score matching were applied to assess the association between PVCs and adverse clinical outcome. Average follow-up time was 10±1 year. In all, 1403 subjects expired, 1301 subjects were hospitalized in the cardiovascular (CV) ward, 3384 were hospitalized for any reason, and 631 subjects developed new-onset heart failure (HF). The optimal cut-off PVC frequency (12 beats per day) was obtained through receiver operator characteristic curves, with a sensitivity of 58.4% and specificity of 59.8%. Upon multivariate analysis, a PVC frequency >12 beats per day was an independent predictor for all mortality (hazard ratio [HR]: 1.429, 95% confidence interval [CI]: 1.284-1.590), CV hospitalization (HR: 1.127, 95% CI: 1.008-1.260), all-cause hospitalization (HR 1.094, 95% CI: 1.021-1.173), and new-onset HF (HR: 1.411, 95% CI: 1.203-1.655). Subjects with a PVC frequency>12 beats per day had an increased risk of cardiac death attributable to HF and sudden cardiac death. The incidence rates for mortality and HF were significantly increased in cases of raised PVC frequency. Propensity-score matching analysis also echoed the main findings. Increased PVC burden was associated with a higher incidence of all-cause mortality, CV hospitalization, all-cause hospitalization, and new-onset HF which was independent of other clinical risk factors.

AB - The long-term clinical impact of premature ventricular complexes (PVCs) on mortality and morbidity has not been fully studied. This study aimed to investigate the association between the burden of PVCs and adverse clinical outcome. A total of 5778 subjects, who were pacemaker-free and ventricular tachycardia-free at baseline, received 24-hour electrocardiography monitoring between January 1, 2002 and December 31, 2004. Clinical event data were retrieved from the Bureau of National Health Insurance of Taiwan. Multivariate Cox hazards regression models and propensity-score matching were applied to assess the association between PVCs and adverse clinical outcome. Average follow-up time was 10±1 year. In all, 1403 subjects expired, 1301 subjects were hospitalized in the cardiovascular (CV) ward, 3384 were hospitalized for any reason, and 631 subjects developed new-onset heart failure (HF). The optimal cut-off PVC frequency (12 beats per day) was obtained through receiver operator characteristic curves, with a sensitivity of 58.4% and specificity of 59.8%. Upon multivariate analysis, a PVC frequency >12 beats per day was an independent predictor for all mortality (hazard ratio [HR]: 1.429, 95% confidence interval [CI]: 1.284-1.590), CV hospitalization (HR: 1.127, 95% CI: 1.008-1.260), all-cause hospitalization (HR 1.094, 95% CI: 1.021-1.173), and new-onset HF (HR: 1.411, 95% CI: 1.203-1.655). Subjects with a PVC frequency>12 beats per day had an increased risk of cardiac death attributable to HF and sudden cardiac death. The incidence rates for mortality and HF were significantly increased in cases of raised PVC frequency. Propensity-score matching analysis also echoed the main findings. Increased PVC burden was associated with a higher incidence of all-cause mortality, CV hospitalization, all-cause hospitalization, and new-onset HF which was independent of other clinical risk factors.

KW - Heart failure

KW - Mortality

KW - Premature ventricular complexes

UR - http://www.scopus.com/inward/record.url?scp=85013066198&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013066198&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000005476

DO - 10.1097/MD.0000000000005476

M3 - Article

VL - 96

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 1

M1 - e5476

ER -