Left atrial volume and cardiovascular outcomes in systolic heart failure: effect of antithrombotic treatment

ESC Heart Failure
Marco R Di TullioWARCEF Investigators

Abstract

Left atrium (LA) dilation is associated with adverse cardiovascular (CV) outcomes. Blood stasis, thrombus formation and atrial fibrillation may occur, especially in heart failure (HF) patients. It is not known whether preventive antithrombotic treatment may decrease the incidence of CV events in HF patients with LA enlargement. We investigated the relationship between LA enlargement and CV outcomes in HF patients and the effect of different antithrombotic treatments. Two-dimensional echocardiography with LA volume index (LAVi) measurement was performed in 1148 patients with systolic HF from the Warfarin versus Aspirin in Reduced Ejection Fraction (WARCEF) trial. Patients were randomized to warfarin or aspirin and followed for 3.4 ± 1.7 years. While the primary aim of the trial was a composite of ischaemic stroke, death, and intracerebral haemorrhage, the present report focuses on the individual CV events, whose incidence was compared across different LAVi and treatment subgroups. After adjustment for demographics and clinical covariates, moderate or severe LA enlargement was significantly associated with total death (hazard ratio 1.6 and 2.7, respectively), CV death (HR 1.7 and 3.3), and HF hospitalization (HR 2.3 and 2.6) but ...Continue Reading

References

Oct 23, 1997·Circulation·B M PsatyP M Rautaharju
Oct 8, 1999·Stroke; a Journal of Cerebral Circulation·M R Di TullioS Homma
Jan 5, 2005·Journal of the American College of Cardiology·Allison M PritchettMargaret M Redfield
Jun 20, 2006·Journal of the American College of Cardiology·Walter P AbhayaratnaTeresa S M Tsang
May 4, 2012·The New England Journal of Medicine·Shunichi HommaUNKNOWN WARCEF Investigators
Dec 19, 2013·Circulation. Heart Failure·Rafael KupersteinRobert Klempfner

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Citations

Jul 30, 2019·Journal of Cardiovascular Electrophysiology·Yi-Gang LiUNKNOWN and other members of the Xinhua Cardiac EP Study Group
Apr 27, 2019·Heart Failure Reviews·Matteo CameliSergio Mondillo
Oct 17, 2019·Heart Failure Reviews·Maria Concetta PastoreUNKNOWN Working Group of Echocardiography of the Italian Society of Cardiology
Apr 4, 2021·Heart and Vessels·Katharina HellhammerPatrick Horn

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Software Mentioned

WARCEF

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