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Intermediate Pause at Daytime Is Associated With Increased Cardiovascular Risk and Mortality: An 8-Year Cohort Study.
Liu, Chih-Min; Lin, Chin-Yu; Chang, Shih-Lin; Lin, Yenn-Jiang; Lo, Li-Wei; Hu, Yu-Feng; Chao, Tze-Fan; Chung, Fa-Po; Tuan, Ta-Chuan; Liao, Jo-Nan; Chen, Yun-Yu; Te, Abigail Louise D; Yamada, Shinya; Kuo, Ling; Li, Hsing-Yuan; Chang, Ting-Yung; Minh, Hoang Quang; Salim, Simon; Ba, Vu Van; Vicera, Jennifer Jeanne B; Wu, Cheng-I; Chuang, Chieh-Mao; Huang, Ting-Chung; Hsieh, Yu-Cheng; Chen, Shih-Ann.
Afiliação
  • Liu CM; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Lin CY; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chang SL; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Lin YJ; Department of Internal Medicine, Yuan-Shan Branch, Taipei Veterans General Hospital, Yilan, Taiwan.
  • Lo LW; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Hu YF; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Chao TF; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chung FP; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Tuan TC; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Liao JN; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Chen YY; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Te ALD; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Yamada S; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Kuo L; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Li HY; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chang TY; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Minh HQ; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Salim S; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Ba VV; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Vicera JJB; Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • Wu CI; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chuang CM; Institute of Epidemiology and Preventive Medicine, College of Public Health National Taiwan University, Taipei, Taiwan.
  • Huang TC; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Hsieh YC; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chen SA; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
J Am Heart Assoc ; 7(12)2018 06 12.
Article em En | MEDLINE | ID: mdl-29895588
BACKGROUND: Long-term cardiovascular risk in patients with intermediate pauses remains unclear. Whether asymptomatic patients with intermediate pauses have increased future cardiovascular events remains unknown. We hypothesize that intermediate pause is associated with increased cardiovascular risk and mortality. METHODS AND RESULTS: We retrospectively analyzed 5291 patients who have pauses of <3 seconds on 24-hour Holter monitoring. Patients with pauses of 2 to 3 seconds constitute the intermediate pause patients, who are further divided into daytime pause (8:00 am-8:00 pm), nighttime pause (8:00 pm-8:00 am), and daytime plus nighttime pause groups depending on the occurring time of the pauses. The rest of the patients (pause <2 seconds) are the no pause group. The multivariate Cox hazards regression model was used to assess the hazard ratio for mortality (primary outcome) and adverse cardiovascular events (secondary outcome). There were 4859 (91.8%) patients in no pause, 248 (4.7%) in nighttime pause, 103 (1.9%) in daytime pause, and 81 (1.5%) in daytime plus nighttime pause groups. After a follow-up of 8.8±1.7 years' follow-up, 343 (6.5%) patients died. The risk for adverse cardiovascular events, including all-cause hospitalization, cardiovascular-cause hospitalization, pacemaker implantation, new-onset atrial fibrillation/heart failure, and transient ischemic attack, were higher in daytime pause and nighttime pause patients than those in the no pause group. Daytime pause (hazard ratio, 2.35; P=0.008) and daytime plus nighttime pause (hazard ratio, 2.26; P=0.016) patients have a higher mortality rate than that in nighttime pause. CONCLUSIONS: Patients with intermediate pause are associated with increased cardiovascular risk. Intermediate pauses occurring at daytime have a higher mortality rate than that at nighttime during long-term follow-up.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bradicardia / Ritmo Circadiano / Frequência Cardíaca Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bradicardia / Ritmo Circadiano / Frequência Cardíaca Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2018 Tipo de documento: Article