Outcomes of Premature Ventricular Contraction-Cardiomyopathy in the Veteran Population: A Secondary Analysis of the CHF-STAT Study
Abstract
Background: Premature ventricular contractions (PVCs) are associated with heart failure and PVC-Cardiomyopathy. The prevalence of PVC-Cardiomyopathy and outcome benefits of PVC suppression are not clear. We sought to assess the rate and outcomes of PVC-Cardiomyopathy from the CHF-STAT trial, a population with cardiomyopathy (LV ejection fraction 10 PVCs per hour). Methods: A secondary analysis of the CHF-STAT study was performed to compare the rate of successful PVC suppression (≥80% PVC reduction), “LV-recovery” (defined as improvement in LVEF ≥10% points) and PVC-Cardiomyopathy between amiodarone and placebo groups at 6 months. PVC-Cardiomyopathy was defined if both, ≥80% PVC reduction and LVEF improvement ≥10% were present at 6 months. Cardiac events (death or resuscitated cardiac arrest) were compared between PVC-Cardiomyopathy vs. non-PVC-Cardiomyopathy during a 5- year follow-up. Results: The rate of successful PVC suppression and LV-recovery were significantly higher in the amiodarone (72 and 39%, respectively) when compared to the placebo group (12 and 16%, respectively; P<0.001), regardless of cardiomyopathy etiology. PVC-Cardiomyopathy was present in 29% and 1.8% of amiodarone and placebo groups, respectively (P<0.001). Similar PVC-Cardiomyopathy rates were found in ischemic (24% amiodarone vs. 2% placebo, P<0.001) and non-ischemic populations (41% amiodarone vs 1.5% placebo, P<0.001). Death and resuscitated cardiac arrest were significantly lower in patients with…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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