Chintan S Desai1, Hongyan Ning, Donald M Lloyd-Jones. 1. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1402, Chicago, IL 60611, USA.
Abstract
BACKGROUND: Individuals with electrocardiographically determined left ventricular hypertrophy (ECG LVH) are at risk of multiple cardiovascular disease (CVD) outcomes simultaneously. The study sought to characterise the competing incidences for subtypes of first CVD events or non-CVD death in those with and without ECG LVH. METHODS: Participants in the Atherosclerosis Risk in Communities (ARIC) Study were included. ECG LVH was defined according to Sokolow-Lyon criteria. Competing Cox models were used to compare hazards for diverse outcomes within groups (e.g., among those with ECG LVH) and for a given event between groups (ECG LVH vs. no ECG LVH). RESULTS: After 15 years, men with ECG LVH at baseline (N=383) had a cumulative incidence of first CVD events and non-CVD deaths of 29.2% and 6.1%, respectively (HR 4.86; 95% CI 3.04 to 7.77). In men without ECG LVH (N=6576) the incidence of any first CVD event and non-CVD death was 18.9% and 6.9%, respectively (HR 2.67; 2.39 to 2.98). Similar associations were observed in women (N=381 with and N=8187 without ECG LVH). Coronary heart disease (CHD) was the most common first event in men with ECG LVH (15.0%) and heart failure was the most common first event in women with ECG LVH (10.5%). After adjustment for risk factors including systolic blood pressure, any CVD event remained the most likely first event. CONCLUSIONS: Among middle-aged individuals with ECG LVH, the most likely first events are CHD in men and heart failure in women; these results may have implications for preventive approaches.
BACKGROUND: Individuals with electrocardiographically determined left ventricular hypertrophy (ECG LVH) are at risk of multiple cardiovascular disease (CVD) outcomes simultaneously. The study sought to characterise the competing incidences for subtypes of first CVD events or non-CVD death in those with and without ECG LVH. METHODS:Participants in the Atherosclerosis Risk in Communities (ARIC) Study were included. ECG LVH was defined according to Sokolow-Lyon criteria. Competing Cox models were used to compare hazards for diverse outcomes within groups (e.g., among those with ECG LVH) and for a given event between groups (ECG LVH vs. no ECG LVH). RESULTS: After 15 years, men with ECG LVH at baseline (N=383) had a cumulative incidence of first CVD events and non-CVD deaths of 29.2% and 6.1%, respectively (HR 4.86; 95% CI 3.04 to 7.77). In men without ECG LVH (N=6576) the incidence of any first CVD event and non-CVD death was 18.9% and 6.9%, respectively (HR 2.67; 2.39 to 2.98). Similar associations were observed in women (N=381 with and N=8187 without ECG LVH). Coronary heart disease (CHD) was the most common first event in men with ECG LVH (15.0%) and heart failure was the most common first event in women with ECG LVH (10.5%). After adjustment for risk factors including systolic blood pressure, any CVD event remained the most likely first event. CONCLUSIONS: Among middle-aged individuals with ECG LVH, the most likely first events are CHD in men and heart failure in women; these results may have implications for preventive approaches.
Authors: J N Woythaler; S L Singer; O L Kwan; R S Meltzer; B Reubner; W Bommer; A DeMaria Journal: J Am Coll Cardiol Date: 1983-08 Impact factor: 24.094
Authors: Björn Dahlöf; Richard B Devereux; Sverre E Kjeldsen; Stevo Julius; Gareth Beevers; Ulf de Faire; Frej Fyhrquist; Hans Ibsen; Krister Kristiansson; Ole Lederballe-Pedersen; Lars H Lindholm; Markku S Nieminen; Per Omvik; Suzanne Oparil; Hans Wedel Journal: Lancet Date: 2002-03-23 Impact factor: 79.321
Authors: Lars H Lindholm; Hans Ibsen; Björn Dahlöf; Richard B Devereux; Gareth Beevers; Ulf de Faire; Frej Fyhrquist; Stevo Julius; Sverre E Kjeldsen; Krister Kristiansson; Ole Lederballe-Pedersen; Markku S Nieminen; Per Omvik; Suzanne Oparil; Hans Wedel; Peter Aurup; Jonathan Edelman; Steven Snapinn Journal: Lancet Date: 2002-03-23 Impact factor: 79.321
Authors: J Mathew; P Sleight; E Lonn; D Johnstone; J Pogue; Q Yi; J Bosch; B Sussex; J Probstfield; S Yusuf Journal: Circulation Date: 2001-10-02 Impact factor: 29.690
Authors: Scott M Grundy; James I Cleeman; C Noel Bairey Merz; H Bryan Brewer; Luther T Clark; Donald B Hunninghake; Richard C Pasternak; Sidney C Smith; Neil J Stone Journal: Circulation Date: 2004-07-13 Impact factor: 29.690
Authors: Walter Oliver; Gwendolyn Matthews; Colby R Ayers; Sonia Garg; Sachin Gupta; Ian J Neeland; Mark H Drazner; Jarett D Berry; Susan Matulevicius; James A de Lemos Journal: Circ Cardiovasc Imaging Date: 2017-02 Impact factor: 7.792
Authors: James A de Lemos; Colby R Ayers; Benjamin D Levine; Christopher R deFilippi; Thomas J Wang; W Gregory Hundley; Jarett D Berry; Stephen L Seliger; Darren K McGuire; Pamela Ouyang; Mark H Drazner; Matthew Budoff; Philip Greenland; Christie M Ballantyne; Amit Khera Journal: Circulation Date: 2017-03-30 Impact factor: 29.690
Authors: Tochi M Okwuosa; Elsayed Z Soliman; Faye Lopez; Kim A Williams; Alvaro Alonso; Keith C Ferdinand Journal: Am Heart J Date: 2014-10-16 Impact factor: 4.749
Authors: Ian J Neeland; Mark H Drazner; Jarett D Berry; Colby R Ayers; Christopher deFilippi; Stephen L Seliger; Vijay Nambi; Darren K McGuire; Torbjørn Omland; James A de Lemos Journal: J Am Coll Cardiol Date: 2012-12-05 Impact factor: 24.094
Authors: Pamela L Lutsey; Alvaro Alonso; Elizabeth Selvin; James S Pankow; Erin D Michos; Sunil K Agarwal; Laura R Loehr; John H Eckfeldt; Josef Coresh Journal: J Am Heart Assoc Date: 2014-06-10 Impact factor: 5.501