Prevalence, correlates, and mortality impacts of ventricular arrhythmia among older men and women: a population-based cohort study in Moscow

BMC Cardiovascular Disorders

Maria A. Shkolnikova¹  Rukijat A. Ildarova¹  Dmitri A. Jdanov²  Vladimir M. Shkolnikov²  Svetlana A. Shalnova³ 

[1] Centre for Cardiac Arrhythmia, Pirogov Russian National Research Medical University, Taldomskaya 2, 125412, Moscow, Russian Federation;Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany;National Research University Higher School of Economics, Bol’shoj Trehsvjatitel’skij Pereulok, 109028, Moscow, Russian Federation;National Research Center for Preventive Medicine, Petroverigskiy pereulok 10, 101990, Moscow, Russian Federation;

关键词: Cardiovascular mortality;    Male–female mortality difference;    Old age;    Ventricular arrhythmia;    Ventricular premature complexes;    Holter monitoring;    ECG;   

DOI  :  10.1186/s12872-021-01883-0

来源: Springer

【 摘 要 】

BackgroundIn Russia, cardiovascular disease (CVD) mortality is high and the mortality gap between men and women is large. Conventional risk factors cannot explain these phenomena. Ventricular arrhythmia (VA) is an important contributor to the death toll in community-based populations. The study examines the prevalence and the mortality impacts of VA in men and women and the role of VA in the male mortality excess at older ages.MethodsThis is a secondary analysis of data from the Stress, Aging, and Health in Russia (SAHR) study that was fielded in 2007–9 in Moscow (1800 individuals, mean age 68.8 years), with mean mortality follow-up of 7.4 years (416 deaths, 248 CVD deaths). Indicators reflecting the frequency and the complexity of VA were derived from 24-h ambulatory ECG recordings. Other covariates were: socio-demographic characteristics, conventional risk factors, markers of inflammation, reported myocardial infarction, and stroke. The impacts of VA and other variables on CVD and all-cause mortality among men and women were estimated with the proportional hazard models. We assessed the contributions of VAs to the male–female mortality gap using hazard models that do and do not include groups of the predictors. Logistic models were used to assess the associations between VA and other biomarkers.ResultsVAs were about twice as prevalent among men as among women. In both sexes, they were significantly associated with CVD and all-cause mortality independently of conventional risk factors. The highest hazard ratios (HRs) for CVD death were found for the runs of ventricular premature complexes (VPCs) HR = 2.45, 95% CI 1.63–3.68 for men and 2.75, 95% CI 1.18–6.40 for women. The mortality impacts of the polymorphic VPCs were significant among men only (HR = 1.50, 95% CI 1.08–2.07). VA indicators can potentially explain 12.3% and 9.1% of the male–female gaps in mortality from CVD and all causes, respectively. VAs were associated with ECG-registered ischemic problems and reported MI, particularly among men.ConclusionsVA indicators predicted mortality in older Muscovites independently of other risk factors, and have the potential to explain a non-trivial share of the excess male mortality. The latter may be related to more severe coronary problems in men compared to women.

【 授权许可】

CC BY