Long-term outcomes associated with prolonged PR interval in the general Japanese population

Hisamatsu, Takashi; Miura, Katsuyuki; Fujiyoshi, Akira; Okamura, Tomonori; Nagasawa, Shin‐ya; Horie, Minoru; Okayama, Akira; Ueshima, Hirotsugu

doi:10.1016/j.ijcard.2015.02.028

Cited by 12 publications

(8 citation statements)

References 7 publications

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“…In addition, age is known to be associated with increased risk of mortality and cardiovascular disease such as ischaemic heart disease and heart failure. We observed a greater mean age in patients in the prolonged PR interval group compared with normal PR interval group in several studies 4 12 13 17 19. However, the majority of the included studies adjusted for age which suggests that the increased risk of cardiovascular events with 1°HB cannot be explained by ageing alone.…”

Section: Discussionmentioning

confidence: 75%

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Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

Kwok

Rashid

Beynon

et al. 2016

Heart

104

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Objective: First-degree atrioventricular block is frequently encountered in clinical practice and is generally considered a benign process. However, there is emerging evidence that prolonged PR interval may be associated with adverse outcomes. This study aims to determine if prolonged PR interval is associated with adverse cardiovascular outcomes and mortality. Methods:We searched MEDLINE and EMBASE for studies that evaluated clinical outcomes associated with prolonged and normal PR intervals. Relevant studies were pooled using random effects meta-analysis for risk of mortality, cardiovascular mortality, heart failure, coronary heart disease, atrial fibrillation and stroke or transient ischemic attack.Sensitivity analyses were performed considering the population type and use of adjustments.Results: Our search yielded 14 studies that were undertaken between 1972 and 2011 with 400,750 participants. Among the studies that adjusted for potential confounders, the pooled results suggest an increased risk of mortality with prolonged PR interval RR 1.24 95%CI 1.02-1.51, 5 studies. Prolonged PR interval was associated with significant risk of heart failure or left ventricular dysfunction (RR 1.39 95%CI 1.18-1.65, 3 studies) and atrial fibrillation (RR 1.45 95%CI 1.23-1.71, 8 studies) but not cardiovascular mortality, coronary heart disease or myocardial infarction or stroke or TIA. Similar observations were recorded when limited to studies of first-degree heart block. Conclusions:Data from observational studies suggests a possible association between prolonged PR interval and significant increases in atrial fibrillation, heart failure and mortality. Future prospective studies are needed to confirm the relationships reported, consider possible mechanisms and define the optimal monitoring strategy for such patients.

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Section: Discussionmentioning

confidence: 75%

“…There were a total of 400 750 participants among the 14 studies (11 prospective cohort studies,4 10–13 17 19–23 3 retrospective cohort studies14–16). The mean age from the 10 studies was 56 years and the percentage of participants that were male ranged from 18% to 100%.…”

Section: Resultsmentioning

confidence: 99%

Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

Kwok

Rashid

Beynon

et al. 2016

Heart

104

View full text Add to dashboard Cite

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“…Compared with the aforementioned published estimates (1 to 2%) (among Europeans and Americans with a mean age of about 50 years), the prevalence was similar, at 1.9%, in a Japanese population aged 30–95 years (mean: 50 years) [11]. However, first-degree AVB was defined as a PR interval ≥ 0.20 s in the former studies and ≥ 0.22 s in the Japanese study [11]. Both our population and the Japanese population belong to the Asian race, and our criterion was PR interval > 0.20 s; therefore, it seems reasonable for our AVB prevalence (3.4%) to be higher than those reported in the aforementioned studies.…”

Section: Discussionmentioning

confidence: 84%

“…Further, the prevalence of first-degree AVB is affected by the definition used, and differences in race may also have an important impact [13]. Compared with the aforementioned published estimates (1 to 2%) (among Europeans and Americans with a mean age of about 50 years), the prevalence was similar, at 1.9%, in a Japanese population aged 30–95 years (mean: 50 years) [11]. However, first-degree AVB was defined as a PR interval ≥ 0.20 s in the former studies and ≥ 0.22 s in the Japanese study [11].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of first-degree AVB, which is 1–2% among the general population in developed countries [4, 5, 10–12], is associated with race [13]. In Asia, the prevalence of first-degree AVB has only been reported for Japan (PR interval ≥ 0.22 s) [11] and Korea (only in patients with hypertension) [14]. No epidemiologic studies have established the prevalence of first-degree AVB in developing countries in Asia.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of first-degree atrioventricular block and the associated risk factors: a cross-sectional study in rural Northeast China

Xing

Lin

et al. 2019

BMC Cardiovasc Disord

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Background: First-degree atrioventricular block (AVB) has traditionally been regarded as a benign condition but recent studies have challenged this conception. Prevalence of 1-2% have been reported in developed countries in Asia. However, no epidemiologic studies have established the prevalence of first-degree AVB in developing countries. The aim of the study was to investigate the prevalence of first-degree AVB in rural northeast China and identify the associated risk factors. Methods: This cross-sectional study was undertaken from September 2017 to May 2018 in rural areas of Liaoning Province. It involved 10,926 participants aged ≥40 years (85.3% of those who were eligible). First-degree AVB was confirmed by at least two independent cardiologists. Risk factors were evaluated using stepwise logistic regression. Results: The prevalence of first-degree AVB was 3.4% (95% confidence interval [CI]: 3.0-3.8%). Males had a higher prevalence than females (5.1% vs. 2.2%, p < 0.001). The regression model involving all participants showed that age (odds ratio [OR]: 1.32; p <0.001), male sex (OR: 1.72; p = 0.001), height (OR: 1.25; p = 0.008), systolic blood pressure (SBP) (OR: 1.15; p = 0.003), triglycerides (TG) (OR: 1.10; p < 0.001), high-density lipoprotein cholesterol (HDL-C) (OR: 0.73; p < 0.001), heart rate (OR: 0.78; p < 0.001), and exercising regularly (OR: 0.73; p = 0.030) were independent risk factors. Conclusions: First-degree AVB is highly prevalent in rural areas of northeast China. The associated independent risk factors include being male, older, and taller, higher SBP and TG, lower HDL-C and heart rate, and lack of exercise.

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First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years

et al. 2021

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Long-term outcomes associated with prolonged PR interval in the general Japanese population

Cited by 12 publications

References 7 publications

Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

Prevalence of first-degree atrioventricular block and the associated risk factors: a cross-sectional study in rural Northeast China

First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years

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