July 10, 2012Heart
The prognostic significance of premature ventricular complexes in adults without clinically apparent heart disease: a meta-analysis and systematic review
Why the study?
Does the presence of premature ventricular complexes increase the risk of mortality or ischaemic heart disease in adults without clinically apparent heart disease?
Population
Adults without clinically apparent heart disease (pooled from 8 controlled studies)
Comparison
Presence of premature ventricular complexes on… vs Absence of premature ventricular complexes (PVCs)
Design
Meta-analysis
Authors
Discussion
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Implication
Incidental PVCs may prompt cardiovascular risk assessment in apparently healthy adults; leaves open causality versus undetected structural disease.
Key Points
- This research aims to assess the long-term consequences of premature ventricular complexes (PVCs) in adults without evident heart disease.
- Conducted a meta-analysis and systematic review of studies on adults without heart disease.
- Analyzed outcomes of all-cause mortality, cardiovascular mortality, sudden cardiac death, and development of ischemic heart disease.
- Used random effects models and meta-regression to evaluate predictors of events.
- Eight studies were included, showing a pooled odds ratio (OR) of 1.72 (95% CI 1.28 to 2.31) for cardiovascular events in patients with PVCs.
- Mean sample age, diabetes, and hypertension were identified as significant predictors of cardiovascular events.
- Increased events were noted only in studies with 100% male populations.
Structured PICO
Does the presence of premature ventricular complexes increase the risk of mortality or ischaemic heart disease in adults without clinically apparent heart disease?
P
Population
Adults without clinically apparent heart disease (pooled from 8 controlled studies)
I
Intervention
Presence of premature ventricular complexes (PVCs) on ECG recording
C
Comparator
Absence of premature ventricular complexes (PVCs)
O
Outcome
Composite of all-cause mortality, cardiovascular mortality, sudden cardiac death or development of ischaemic heart diseasehard clinical
In adults without clinically apparent heart disease, PVCs are associated with increased adverse cardiovascular outcomes, though this risk appears driven by older patients with higher cardiovascular risk who may have undiagnosed structural heart disease.
Limitations
- Most studies did not use advanced tests (echocardiogram or stress test) to rule out structural heart disease
- Possible inadvertent inclusion of patients with occult structural heart disease
Cite This Study
Lee et al. (2012) studied this question.