Premature ventricular complexes and the risk of incident stroke: The atherosclerosis risk in communities (ARIC) study

Sunil K. Agarwal, Gerardo Heiss, Pentti M. Rautaharju, Eyal Shahar, Mark W. Massing, Ross J. Simpson

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE-: Premature ventricular complexes (PVCs) on a 2-minute electrocardiogram are a common, largely asymptomatic finding associated with increased risk of coronary heart disease and death. They may reflect atherosclerosis or other pathogenic pathways that predispose to arrhythmias and stroke. METHODS-: We conducted a prospective evaluation of the Atherosclerosis Risk In Communities Study cohort (n=14 783) of middle-aged men and women to assess whether the presence of PVCs at study baseline (1987 to 1989) influenced the risk of incident stroke through December 31, 2004. RESULTS-: PVCs were seen in 6.1% of the participants at baseline, and 729 (4.9%) had incident stroke. The unadjusted cumulative proportion of incident stroke in individuals with any PVC was 6.6% compared with 4.1% in those without PVC. The unadjusted hazard ratio of incident stroke in individuals with any PVC compared with those without any PVCs was 1.71 (95% CI, 1.33 to 2.20). Among individuals without hypertension and diabetes at baseline, PVCs were independently associated with incident stroke (hazard ratio: 1.72; 95% CI: 1.14 to 2.59). Among those with either diabetes or hypertension, the presence of any PVCs did not increase the risk of stroke. The association was stronger for noncarotid embolic stroke than for thrombotic stroke and its magnitude increased with higher frequency of PVCs. CONCLUSIONS-: Frequent PVCs are associated with risk of incident stroke in participants free of hypertension and diabetes. This suggests that PVCs may contribute to atrioventricular remodeling or may be a risk marker for incident stroke, particularly embolic stroke.

Original languageEnglish (US)
Pages (from-to)588-593
Number of pages6
JournalStroke
Volume41
Issue number4
DOIs
StatePublished - Apr 2010

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Ventricular Premature Complexes
Atherosclerosis
Stroke
Hypertension
Coronary Disease
Cardiac Arrhythmias
Electrocardiography
Cohort Studies

Keywords

  • Arrhythmia
  • Atrial fibrillation
  • Premature ventricular complexes
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Premature ventricular complexes and the risk of incident stroke : The atherosclerosis risk in communities (ARIC) study. / Agarwal, Sunil K.; Heiss, Gerardo; Rautaharju, Pentti M.; Shahar, Eyal; Massing, Mark W.; Simpson, Ross J.

In: Stroke, Vol. 41, No. 4, 04.2010, p. 588-593.

Research output: Contribution to journalArticle

Agarwal, Sunil K. ; Heiss, Gerardo ; Rautaharju, Pentti M. ; Shahar, Eyal ; Massing, Mark W. ; Simpson, Ross J. / Premature ventricular complexes and the risk of incident stroke : The atherosclerosis risk in communities (ARIC) study. In: Stroke. 2010 ; Vol. 41, No. 4. pp. 588-593.
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AB - BACKGROUND AND PURPOSE-: Premature ventricular complexes (PVCs) on a 2-minute electrocardiogram are a common, largely asymptomatic finding associated with increased risk of coronary heart disease and death. They may reflect atherosclerosis or other pathogenic pathways that predispose to arrhythmias and stroke. METHODS-: We conducted a prospective evaluation of the Atherosclerosis Risk In Communities Study cohort (n=14 783) of middle-aged men and women to assess whether the presence of PVCs at study baseline (1987 to 1989) influenced the risk of incident stroke through December 31, 2004. RESULTS-: PVCs were seen in 6.1% of the participants at baseline, and 729 (4.9%) had incident stroke. The unadjusted cumulative proportion of incident stroke in individuals with any PVC was 6.6% compared with 4.1% in those without PVC. The unadjusted hazard ratio of incident stroke in individuals with any PVC compared with those without any PVCs was 1.71 (95% CI, 1.33 to 2.20). Among individuals without hypertension and diabetes at baseline, PVCs were independently associated with incident stroke (hazard ratio: 1.72; 95% CI: 1.14 to 2.59). Among those with either diabetes or hypertension, the presence of any PVCs did not increase the risk of stroke. The association was stronger for noncarotid embolic stroke than for thrombotic stroke and its magnitude increased with higher frequency of PVCs. CONCLUSIONS-: Frequent PVCs are associated with risk of incident stroke in participants free of hypertension and diabetes. This suggests that PVCs may contribute to atrioventricular remodeling or may be a risk marker for incident stroke, particularly embolic stroke.

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