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Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care
SIMPLE SUMMARY: It is largely unknown how frequently cancer patients seen in routine care show ventricular arrhythmias during 24-h electrocardiograms. We have found that non–sustained ventricular tachycardia episodes of ≥3 and ≥4 beats duration were more frequent in cancer patients than controls. No...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151948/ https://www.ncbi.nlm.nih.gov/pubmed/34065780 http://dx.doi.org/10.3390/cancers13102303 |
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author | Albrecht, Annemarie Porthun, Jan Eucker, Jan Coats, Andrew J.S. von Haehling, Stephan Pezzutto, Antonio Karakas, Mahir Riess, Hanno Keller, Ulrich Landmesser, Ulf Haverkamp, Wilhelm Anker, Stefan D. Anker, Markus S. |
author_facet | Albrecht, Annemarie Porthun, Jan Eucker, Jan Coats, Andrew J.S. von Haehling, Stephan Pezzutto, Antonio Karakas, Mahir Riess, Hanno Keller, Ulrich Landmesser, Ulf Haverkamp, Wilhelm Anker, Stefan D. Anker, Markus S. |
author_sort | Albrecht, Annemarie |
collection | PubMed |
description | SIMPLE SUMMARY: It is largely unknown how frequently cancer patients seen in routine care show ventricular arrhythmias during 24-h electrocardiograms. We have found that non–sustained ventricular tachycardia episodes of ≥3 and ≥4 beats duration were more frequent in cancer patients than controls. Non–sustained ventricular tachycardia with ≥4 beats and ≥20 premature ventricular contractions/day seen in routine 24-h electrocardiograms of patients with cancer carry prognostic relevance. ABSTRACT: Aims: It is largely unknown whether cancer patients seen in routine care show ventricular arrhythmias in 24 h electrocardiograms (ECGs), and whether when they are detected they carry prognostic relevance. Methods and Results: We included 261 consecutive cancer patients that were referred to the department of cardiology for 24 h ECG examination and 35 healthy controls of similar age and sex in the analysis. To reduce selection bias, cancer patients with known left ventricular ejection fraction <45% were not included in the analysis. Non–sustained ventricular tachycardia (NSVT) episodes of either ≥3 and ≥4 beats duration were more frequent in cancer patients than controls (17% vs. 0%, p = 0.0008; 10% vs. 0%, p = 0.016). Premature ventricular contractions (PVCs)/24 h were not more frequent in cancer patients compared to controls (median (IQR), 26 (2–360) vs. 9 (1–43), p = 0.06; ≥20 PVCs 53% vs. 37%, p = 0.07). During follow-up, (up to 7.2 years, median 15 months) of the cancer patients, 158 (61%) died (1-/3-/5-year mortality rates: 45% [95%CI 39–51%], 66% [95%CI 59–73%], 73% [95%CI 64–82%]). Both non-sustained ventricular tachycardia of ≥4 beats and ≥20 PVCs/24 h independently predicted mortality in univariate and multivariate survival analyses, adjusted for all other univariate predictors of mortality as well as relevant clinical factors, including cancer stage and type, performance status (ECOG), prior potentially cardiotoxic anti-cancer drug therapy, coronary artery disease, potassium concentration, and haemoglobin (multivariate adjusted hazard ratios: NSVT ≥4 beats [HR 1.76, p = 0.022], ≥20 PVCs/24 h [HR 1.63, p < 0.0064]). Conclusions: NSVT ≥4 beats and ≥20 PVCs/day seen in routine 24 h ECGs of patients with cancer carry prognostic relevance. |
format | Online Article Text |
id | pubmed-8151948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81519482021-05-27 Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care Albrecht, Annemarie Porthun, Jan Eucker, Jan Coats, Andrew J.S. von Haehling, Stephan Pezzutto, Antonio Karakas, Mahir Riess, Hanno Keller, Ulrich Landmesser, Ulf Haverkamp, Wilhelm Anker, Stefan D. Anker, Markus S. Cancers (Basel) Article SIMPLE SUMMARY: It is largely unknown how frequently cancer patients seen in routine care show ventricular arrhythmias during 24-h electrocardiograms. We have found that non–sustained ventricular tachycardia episodes of ≥3 and ≥4 beats duration were more frequent in cancer patients than controls. Non–sustained ventricular tachycardia with ≥4 beats and ≥20 premature ventricular contractions/day seen in routine 24-h electrocardiograms of patients with cancer carry prognostic relevance. ABSTRACT: Aims: It is largely unknown whether cancer patients seen in routine care show ventricular arrhythmias in 24 h electrocardiograms (ECGs), and whether when they are detected they carry prognostic relevance. Methods and Results: We included 261 consecutive cancer patients that were referred to the department of cardiology for 24 h ECG examination and 35 healthy controls of similar age and sex in the analysis. To reduce selection bias, cancer patients with known left ventricular ejection fraction <45% were not included in the analysis. Non–sustained ventricular tachycardia (NSVT) episodes of either ≥3 and ≥4 beats duration were more frequent in cancer patients than controls (17% vs. 0%, p = 0.0008; 10% vs. 0%, p = 0.016). Premature ventricular contractions (PVCs)/24 h were not more frequent in cancer patients compared to controls (median (IQR), 26 (2–360) vs. 9 (1–43), p = 0.06; ≥20 PVCs 53% vs. 37%, p = 0.07). During follow-up, (up to 7.2 years, median 15 months) of the cancer patients, 158 (61%) died (1-/3-/5-year mortality rates: 45% [95%CI 39–51%], 66% [95%CI 59–73%], 73% [95%CI 64–82%]). Both non-sustained ventricular tachycardia of ≥4 beats and ≥20 PVCs/24 h independently predicted mortality in univariate and multivariate survival analyses, adjusted for all other univariate predictors of mortality as well as relevant clinical factors, including cancer stage and type, performance status (ECOG), prior potentially cardiotoxic anti-cancer drug therapy, coronary artery disease, potassium concentration, and haemoglobin (multivariate adjusted hazard ratios: NSVT ≥4 beats [HR 1.76, p = 0.022], ≥20 PVCs/24 h [HR 1.63, p < 0.0064]). Conclusions: NSVT ≥4 beats and ≥20 PVCs/day seen in routine 24 h ECGs of patients with cancer carry prognostic relevance. MDPI 2021-05-12 /pmc/articles/PMC8151948/ /pubmed/34065780 http://dx.doi.org/10.3390/cancers13102303 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Albrecht, Annemarie Porthun, Jan Eucker, Jan Coats, Andrew J.S. von Haehling, Stephan Pezzutto, Antonio Karakas, Mahir Riess, Hanno Keller, Ulrich Landmesser, Ulf Haverkamp, Wilhelm Anker, Stefan D. Anker, Markus S. Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care |
title | Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care |
title_full | Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care |
title_fullStr | Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care |
title_full_unstemmed | Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care |
title_short | Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care |
title_sort | spontaneous non-sustained ventricular tachycardia and premature ventricular contractions and their prognostic relevance in patients with cancer in routine care |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151948/ https://www.ncbi.nlm.nih.gov/pubmed/34065780 http://dx.doi.org/10.3390/cancers13102303 |
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