2006年12月29日美国研究人员报道，无论是否发现冠心病相关证据，电生理检查发现心室过早综合波（VPCs）的患者同无VPCs患者相比，冠心病（CHD）发病率增高2倍，研究人员认为，看起来很健康患者中发现VPCs，“可能要警惕高度关注心血管疾病的风险。”
Ross Simpson（Chapel Hill北卡罗来纳大学）及其同事们对年龄在45到64岁之间的15070名患者进行了社区人群动脉粥样硬化风险（ARIC）的前瞻性分析研究。研究人员对CHD患者及非CHD患者进行研究，评估VPCs同CHD风险之间的关系，认为VPCs患者更容易出现CHD。通过2分钟的电生理检查对940（6.2%）名受试者进行VPCs鉴定。10年随访研究发现，VPCs人群同非VPCs人群相比，CHD风险增高3倍以上，分别为7.8%和2.1%。调整心血管风险因素和治疗后，VPCs受试者CHD发病率风险是非VPCs受试者发病率的2倍，而且同基线水平非CHD患者相比，VPCs受试者CHD发病风险持续升高。
“可以将VPCs患者归入高风险类别，并指导医师更一步加强CHD风险因素如血压、胆固醇及吸烟的治疗” ，研究人员总结认为，“加强心血管风险因素的治疗，特别是高血压，将是对临床电生理检查发现VPCs患者最好的回应。”
Ventricular premature complexes predict CHD mortality
29 December 2006
People with ventricular premature complexes (VPCs) on electrocardiography are twice as likely to die of coronary heart disease (CHD) as people without VPCs, irrespective of whether they already show evidence of CHD, US researchers report.
As a consequence, they say, a clinical finding of VPCs even in apparently healthy patients "may warrant heightened awareness of and attention to cardiovascular risk management."
Ross Simpson (University of North Carolina at Chapel Hill) and colleagues conducted a prospective analysis of the population-based Atherosclerosis Risk in Communities (ARIC) study of 15,070 patients aged between 45 and 64 years.
They wanted to evaluate the association between VPCs and CHD risk among people with and without established CHD, given that VPCs are more likely to appear in patients with established CHD.
VPCs were identified on a single 2-minute electrocardiogram in 940 (6.2%) participants.
Over a 10-year follow-up period, people with VPCs had more than 3 times the rate of CHD mortality of those without VPCs, at 7.8% versus 2.1%.
After adjustment for cardiovascular risk factors and therapy, participants with VPCs had twice the risk of CHD mortality of those without them, an increase which remained constant when considering those without CHD at baseline.
"The presence of VPCs may place patients in higher risk categories and should lead physicians to recommend more aggressive treatment of modifiable risk factors for CHD such as blood pressure, cholesterol, and smoking," the authors write in the American Journal of Cardiology.
They conclude: "Aggressive management of cardiovascular risk factors, especially hypertension, would seem to be a prudent clinical response to a finding of VPCs on electrocardiography."
Am J Cardiol 2006; 98: 1609-1612
http://www.incirculation.net/NewsItem/Ventricular-premature-complexes-predict-CHD-mortal.aspx
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