Premature ventricular complexes (PVCs) are a risk factor for cardiac death in the general population. Whether the risk associated with PVCs was affected by the presence of left ventricular hypertrophy (LVH) was investigated.Design and Method:
A prospective observational study was conducted in a Japanese general population (JMS cohort study). ECG data were obtained between April 1992 and July 1995 in an annual health check. Subjects who had a prior history of myocardial infarction and stroke were excluded. LVH was diagnosed by ECG using Cornell product criteria. Cox's proportional hazard model was used to calculate the hazard ratios (HRs) of cardiovascular mortality of subjects with PVCs compared to those without PVCs.Results:
A total of 11,158 subjects with ECG data were analyzed. Patients were followed-up for an average of 11.9 years. Overall, 1.4% of men and 1.1% of women had PVCs on ECG. There were 47 cardiac deaths in men and 45 in women during the follow-up period. The HRs of cardiovascular death were significantly greater in the subjects with PVCs than in those without (HR = 5.29, 95% confidence interval [CI] = 1.64–17.0 in males and HR = 2.14, 95%CI = 0.29–15.5 in females). The risk in subjects with PVCs was significant only in men, even after adjustment for age (HR = 3.73, 95%CI = 1.16–12.0) and other conventional confounding factors (HR = 3.98, 95%CI = 1.21–13.0). On multivariate analysis, the risk in subjects with PVCs was especially high in those with LVH (HR = 18.5, 95%CI = 3.57–95.8 in males; HR = 12.5, 95%CI = 1.34–115 in females), but not in those without LVH.Conclusions:
In the general population, PVC is associated with the risk of cardiovascular death, especially in those with LVH on ECG.