What is the clinical evidence from this study?

Study design: Cohort. Population: Myocardial infarction (n=2035). Intervention: Ventricular premature beats (VPB) vs. No VPB. Primary outcome: Death.

What question did this study set out to answer?

To evaluate the prognostic significance of ventricular premature beats (VPB) in survivors of myocardial infarction.

March 5, 1973

Prognostic Importance of Premature Beats Following Myocardial Infarction

Key Result

The presence of ventricular premature beats on a resting baseline ECG in survivors of myocardial infarction was associated with increased 3-year mortality compared to no VPB (21.7% vs 11.4%).

Key Points

To evaluate the prognostic significance of ventricular premature beats (VPB) in survivors of myocardial infarction.
Analyzed the electrocardiograms of 2,035 myocardial infarction survivors to identify VPB presence.
Conducted a three-year follow-up to track death rates among patients with and without VPB.
Focused on mortality relative to VPB frequency and patterns.
Mortality rate among patients with VPB was 21.7% compared to 11.4% for those without VPB (p<0.001).
High VPB frequency (in pairs or runs) was independently associated with increased risk of death.
The risk increase was consistent regardless of other electrocardiographic and clinical variables.

Study Design

Type

Cohort (n=2,035)

Multicenter

Yes

Structured PICO

Does the presence of ventricular premature beats on baseline ECG increase the risk of death in male survivors of myocardial infarction?

Population

2,035 male survivors of myocardial infarction (placebo-treated patients in the nationwide Coronary Drug Project)

Intervention

Presence of one or more ventricular premature beats (VPB) in resting baseline electrocardiogram

Comparator

Absence of ventricular premature beats (VPB) in resting baseline electrocardiogram

Outcome

Death (long-term risk of death, including sudden death)hard clinical

The presence and frequency of ventricular premature beats on a resting baseline ECG independently predict an increased long-term risk of death in male survivors of myocardial infarction.

Main Result

Absolute Event Rate: 21.7% vs 11.4%

Abstract

Two hundred thirty-five men among 2,035 survivors of myocardial infarction (11.5%) had one or more ventricular premature beats (VPB) in their resting base-line electrocardiogram. During a three-year follow-up period, deaths were about twice as frequent in those with any VPB (21.7%) as in those with none (11.4%) among the placebo-treated patients in the nationwide Coronary Drug Project. Excess long-term risk of death, including sudden death, was associated with the frequency of VPB, with VPB in pairs or runs, and possibly with early-cycle VPB. The excess risk with these VPB characteristics was independent of the risk associated with other electrocardiographic and clinical characteristics.

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