Relation of ventricular premature complexes to heart failure (from the Atherosclerosis Risk in Communities [ARIC] study)

Sunil K. Agarwal, Ross J. Simpson, Pentti Rautaharju, Alvaro Alonso, Eyal Shahar, Mark Massing, Samir Saba, Gerardo Heiss

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65 Scopus citations


Analogous to rapid ventricular pacing, frequent ventricular premature complexes (VPCs) can predispose over time to cardiomyopathy and subsequent heart failure (HF). We examined the association of frequent VPCs with HF incidence in a population-based cohort, free of HF and coronary heart disease at baseline. At study baseline (1987 to 1989), <1 VPC on a 2-minute rhythm electrocardiographic strip was seen in 5.5% (739 of 13,486) of the middle-age (45 to 64 years old at baseline) white and black, men and women of the Atherosclerosis Risk In Communities cohort. Incident HF was defined as the first appearance of International Classification of Diseases code 428.x in the hospital discharge record or death certificate through 2005. During an average follow-up of 15.6 years, incident HF was seen in 10% the participants (19.4% of those with VPCs vs 9.4% of those without). The age-, race-, and gender-adjusted hazard ratio of HF for VPCs was 1.89 (95% confidence interval 1.59 to 2.24). After multivariable adjustment for potential confounders, the hazard ratio of HF for those with any VPC versus no VPC was 1.63 (95% confidence interval 1.36 to 1.96). After additional adjustment for incident coronary heart disease as a time-varying covariate, the hazard ratio was 1.71 (95% confidence interval 1.42 to 2.08). Those with a greater frequency of VPCs or complex VPCs had similar rates of HF compared to those with a single VPC and all had rates greater than those with no VPC. In conclusion, in this large population-based cohort, the presence of VPCs was associated with incident HF, independent of incident coronary heart disease.

Original languageEnglish (US)
Pages (from-to)105-109
Number of pages5
JournalAmerican Journal of Cardiology
Issue number1
StatePublished - Jan 1 2012

Bibliographical note

Funding Information:
The Atherosclerosis Risk In Communities study is a collaborative study supported by grants N01-HC-55015 , N01-HC-55016 , N01-HC-55018 , N01-HC-55019 , N01-HC-55020 , N01-HC-55021 , N01-HC-55022 from the National Heart, Lung, and Blood Institute , Bethesda, Maryland and several other grants.


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