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Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community
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 standa...
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| Published in: | Journal of the American Heart Association 2017-08, Vol.6 (8), p.n/a |
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| creator | Nguyen, Kaylin T. Vittinghoff, Eric Dewland, Thomas A. 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. |
| description | 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 |
| doi_str_mv | 10.1161/JAHA.117.006028 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_fa258cb0a3614ece8ae79bd1aa2b11f9</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_fa258cb0a3614ece8ae79bd1aa2b11f9</doaj_id><sourcerecordid>1926683645</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5718-e5a13787ff649a3125ce1d01dbc51474fd410cf366503f433ad198bf4ffdf7fb3</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhSMEolXpmh3ykkWn9b-dDdIoDO2gQSwAsbRu_DPjKomHJAPKjkfgGXkSPKRU7QpvfGwff_a9pyheEnxJiCRX75c3y6zUJcYSU_2kOKWYq0VZavz0gT4pzofhFuchqWKifF6cUK2UwJKfFl9Xdkz7CaUOAfoUu23jEaG_f_7aeHBoVV1foHVno_PdiCroXQSLPkxpD-NuukDQOfTWZ41ih8adR1Vq20MXx-lF8SxAM_jzu_ms-PJu9bm6WWw-Xq-r5WZhhSJ64QUQprQKQfISGKHCeuIwcbUVhCseHCfYBialwCxwxsCRUteBh-CCCjU7K9Yz1yW4Nfs-ttBPJkE0fzdSvzXQj9E23gSgQtsaA5OEe-s1eFXWjgDQmpBQZtabmbU_1K13NtfcQ_MI-vikizuzTd-NEFpyzjPg9R2gT98OfhhNGwfrmwY6nw6DISWVUjPJRbZezVbbp2Hofbh_hmBzTNcc081KmTndfOPVw9_d-_9lmQ1iNvyIjZ_-xzuuGc29Z38AskOvdg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1926683645</pqid></control><display><type>article</type><title>Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community</title><source>Wiley-Blackwell Open Access Collection</source><source>PubMed Central</source><creator>Nguyen, Kaylin T. ; Vittinghoff, Eric ; Dewland, Thomas A. ; 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.</creator><creatorcontrib>Nguyen, Kaylin T. ; Vittinghoff, Eric ; Dewland, Thomas A. ; 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.</creatorcontrib><description>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.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.117.006028</identifier><identifier>PMID: 28775064</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>Aged ; atrial fibrillation ; Atrial Fibrillation - mortality ; Atrial Premature Complexes - mortality ; Cardiomyopathies - mortality ; Electrocardiography ; Female ; heart failure ; Heart Failure - mortality ; Humans ; Incidence ; Male ; Middle Aged ; mortality ; Original Research ; premature atrial contractions ; premature ventricular contractions ; Prognosis ; Prospective Studies ; Risk Factors ; United States - epidemiology ; Ventricular Premature Complexes - mortality</subject><ispartof>Journal of the American Heart Association, 2017-08, Vol.6 (8), p.n/a</ispartof><rights>2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5718-e5a13787ff649a3125ce1d01dbc51474fd410cf366503f433ad198bf4ffdf7fb3</citedby><cites>FETCH-LOGICAL-c5718-e5a13787ff649a3125ce1d01dbc51474fd410cf366503f433ad198bf4ffdf7fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586444/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586444/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,11543,27905,27906,46033,46457,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28775064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, Kaylin T.</creatorcontrib><creatorcontrib>Vittinghoff, Eric</creatorcontrib><creatorcontrib>Dewland, Thomas A.</creatorcontrib><creatorcontrib>Dukes, Jonathan W.</creatorcontrib><creatorcontrib>Soliman, Elsayed Z.</creatorcontrib><creatorcontrib>Stein, Phyllis K.</creatorcontrib><creatorcontrib>Gottdiener, John S.</creatorcontrib><creatorcontrib>Alonso, Alvaro</creatorcontrib><creatorcontrib>Chen, Lin Y.</creatorcontrib><creatorcontrib>Psaty, Bruce M.</creatorcontrib><creatorcontrib>Heckbert, Susan R.</creatorcontrib><creatorcontrib>Marcus, Gregory M.</creatorcontrib><title>Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>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.</description><subject>Aged</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - mortality</subject><subject>Atrial Premature Complexes - mortality</subject><subject>Cardiomyopathies - mortality</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>heart failure</subject><subject>Heart Failure - mortality</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>Original Research</subject><subject>premature atrial contractions</subject><subject>premature ventricular contractions</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>United States - epidemiology</subject><subject>Ventricular Premature Complexes - mortality</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>DOA</sourceid><recordid>eNqFkc1u1DAUhSMEolXpmh3ykkWn9b-dDdIoDO2gQSwAsbRu_DPjKomHJAPKjkfgGXkSPKRU7QpvfGwff_a9pyheEnxJiCRX75c3y6zUJcYSU_2kOKWYq0VZavz0gT4pzofhFuchqWKifF6cUK2UwJKfFl9Xdkz7CaUOAfoUu23jEaG_f_7aeHBoVV1foHVno_PdiCroXQSLPkxpD-NuukDQOfTWZ41ih8adR1Vq20MXx-lF8SxAM_jzu_ms-PJu9bm6WWw-Xq-r5WZhhSJ64QUQprQKQfISGKHCeuIwcbUVhCseHCfYBialwCxwxsCRUteBh-CCCjU7K9Yz1yW4Nfs-ttBPJkE0fzdSvzXQj9E23gSgQtsaA5OEe-s1eFXWjgDQmpBQZtabmbU_1K13NtfcQ_MI-vikizuzTd-NEFpyzjPg9R2gT98OfhhNGwfrmwY6nw6DISWVUjPJRbZezVbbp2Hofbh_hmBzTNcc081KmTndfOPVw9_d-_9lmQ1iNvyIjZ_-xzuuGc29Z38AskOvdg</recordid><startdate>201708</startdate><enddate>201708</enddate><creator>Nguyen, Kaylin T.</creator><creator>Vittinghoff, Eric</creator><creator>Dewland, Thomas A.</creator><creator>Dukes, Jonathan W.</creator><creator>Soliman, Elsayed Z.</creator><creator>Stein, Phyllis K.</creator><creator>Gottdiener, John S.</creator><creator>Alonso, Alvaro</creator><creator>Chen, Lin Y.</creator><creator>Psaty, Bruce M.</creator><creator>Heckbert, Susan R.</creator><creator>Marcus, Gregory M.</creator><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>201708</creationdate><title>Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community</title><author>Nguyen, Kaylin T. ; Vittinghoff, Eric ; Dewland, Thomas A. ; 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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5718-e5a13787ff649a3125ce1d01dbc51474fd410cf366503f433ad198bf4ffdf7fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - mortality</topic><topic>Atrial Premature Complexes - mortality</topic><topic>Cardiomyopathies - mortality</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>heart failure</topic><topic>Heart Failure - mortality</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>Original Research</topic><topic>premature atrial contractions</topic><topic>premature ventricular contractions</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>United States - epidemiology</topic><topic>Ventricular Premature Complexes - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, Kaylin T.</creatorcontrib><creatorcontrib>Vittinghoff, Eric</creatorcontrib><creatorcontrib>Dewland, Thomas A.</creatorcontrib><creatorcontrib>Dukes, Jonathan W.</creatorcontrib><creatorcontrib>Soliman, Elsayed Z.</creatorcontrib><creatorcontrib>Stein, Phyllis K.</creatorcontrib><creatorcontrib>Gottdiener, John S.</creatorcontrib><creatorcontrib>Alonso, Alvaro</creatorcontrib><creatorcontrib>Chen, Lin Y.</creatorcontrib><creatorcontrib>Psaty, Bruce M.</creatorcontrib><creatorcontrib>Heckbert, Susan R.</creatorcontrib><creatorcontrib>Marcus, Gregory M.</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, Kaylin T.</au><au>Vittinghoff, Eric</au><au>Dewland, Thomas A.</au><au>Dukes, Jonathan W.</au><au>Soliman, Elsayed Z.</au><au>Stein, Phyllis K.</au><au>Gottdiener, John S.</au><au>Alonso, Alvaro</au><au>Chen, Lin Y.</au><au>Psaty, Bruce M.</au><au>Heckbert, Susan R.</au><au>Marcus, Gregory M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2017-08</date><risdate>2017</risdate><volume>6</volume><issue>8</issue><epage>n/a</epage><issn>2047-9980</issn><eissn>2047-9980</eissn><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.</abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>28775064</pmid><doi>10.1161/JAHA.117.006028</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged atrial fibrillation Atrial Fibrillation - mortality Atrial Premature Complexes - mortality Cardiomyopathies - mortality Electrocardiography Female heart failure Heart Failure - mortality Humans Incidence Male Middle Aged mortality Original Research premature atrial contractions premature ventricular contractions Prognosis Prospective Studies Risk Factors United States - epidemiology Ventricular Premature Complexes - mortality |
| title | Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community |
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