Heart failure & cardiomyopathies
Prognostic implications of premature ventricular contractions and non-sustained ventricular tachycardia in light-chain cardiac amyloidosis
Authors' conclusion
PVC count, burden, and NSVT significantly correlated with adverse VA/SCD during follow-up in patients with AL-CA. Higher PVC counts/burdens added incremental value for predicting cardiac death.
Study context
- Population
- Patients with light-chain cardiac amyloidosis (AL-CA) at modified 2004 Mayo stages II-IIIb, February 2014 to December 2020131 followed up
- Participants
- 143 patients
- Exposure
- Premature ventricular contractions (PVC) and non-sustained ventricular tachycardia (NSVT) on Holter as predictors of outcome
- Outcome
- (i) New-onset adverse VA or SCD; (ii) cardiac death
- Follow-up
- During (median 24.4 months)
Main finding
As reported in the abstract
NSVT predictive of adverse ventricular arrhythmia (VA)/sudden cardiac death (SCD): HR (95% CI 3.06-60.18), P < 0.001
13.57
Log-transformed PVC counts predictive of adverse VA/SCD: HR (95% CI 1.15-1.86), P = 0.002
1.46
PVC burden predictive of adverse VA/SCD: HR (95% CI 1.14-1.80), P = 0.002
1.43
Adverse VA/SCD events, n
15
Observational data: associations, not effects.
Further findings
Cardiac death
- Cardiac deaths, n
- 71
- Highest tertile of PVC counts: HR (95% CI 1.27-4.28), P = 0.006
- 2.33
- Highest tertile of PVC burden: HR (95% CI 1.42-4.69), P = 0.002
- 2.58
- NSVT not associated: HR (95% CI 0.67-1.98), P = 0.603
- 1.16
Incremental value over modified 2004 Mayo stage for cardiac death (C index)
- C index, Mayo stage alone
- 0.681
- C index, with PVC counts
- 0.712
- C index, with PVC burden
- 0.717
- P values <0.05
Prevalence on Holter · on admission
- PVC present, n (%) = 132
- 92.31%
- NSVT present, n (%) = 50
- 34.97%
- In-hospital deaths, n (%) = 12
- 8.4%
Original publication
Summarised from the published abstract; every number is checked against it