Left Atrial Diameter in the Prediction of Thromboembolic Event and Death in Atrial Fibrillation

Journal of Clinical Medicine

卷:11

Poom Sairat¹  Rungroj Krittayaphong¹  Arjbordin Winijkul¹ 

[1] Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;

关键词: incremental prognostic value;    left atrial size;    thromboembolism;    patients;    non-valvular atrial fibrillation;   

DOI  :  10.3390/jcm11071838

来源: DOAJ

【 摘 要 】

Background: This study aimed to determine the predictive value of left atrial diameter (LAD), and the incremental prognostic value of LAD in combination with CHA₂DS₂-VASc score for predicting thromboembolic event and all-cause death in patients with non-valvular atrial fibrillation (AF). Methods: This is a prospective study from 27 hospitals during 2014–2017. LADi is LAD data indexed by body surface area, and LADi in the 4th quartile (LADi Q4) was considered high. Results: A total of 2251 patients (mean age 67.4 years, 58.6% male) were enrolled. Mean follow-up duration was 32.3 months. Rates of thromboembolic events and all-cause death were significantly higher in LADi Q4 patients than in LADi Q1–3 patients (2.89 vs. 1.11 per 100 person-years, p < 0.001, and 7.52 vs. 3.13 per 100 person-years, p < 0.001, respectively). LADi Q4 is an independent predictor of thromboembolic events and all-cause death with an adjusted hazard ratio and 95% confidence interval of 1.94 (1.24–3.05) and 1.81 (1.38–2.37), respectively. LADi has incremental prognostic value on top of the CHA₂DS₂-VASc score with the increase in global chi-square for thromboembolism (p = 0.005) and all-cause death (p < 0.001). Conclusions: LADi is an independent predictor of thromboembolic event and has incremental prognostic value in combination with CHA₂DS₂-VASc score in AF patients.

【 授权许可】

Unknown