Abstract 12799: Left Atrial Enlargement is an Independent Risk Factor of Stroke or Systemic Embolism in Atrial Fibrillation Patients: The Fushimi AF Registry
Introduction: Atrial fibrillation (AF) is a common arrhythmic disorder and increasing significantly. Stroke or systemic embolism (SE) is a devastating complication of AF. Controversy exists regarding whether left atrial enlargement is a risk factor of stroke/SE in AF patients.
Hypothesis: Left atrial enlargement might be associated with the incidence of stroke/SE.
Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, which represented a typical urban community in Japan. We started to enroll patients from March 2011, and follow-up data were available for 2,724 patients by April 2015 (median follow-up period 808 days). Left atrial enlargement (LAE) was diagnosed if the left atrial diameter measured by transthoracic echocardiography was >45 mm. We compared the backgrounds and incidences of events during follow-up period between those with LAE and those without it (non-LAE).
Results: Backgrounds and incidences of events between LAE and non-LAE are shown in the Table. LAE group showed higher incidence of stroke/SE during follow-up period, compared with non-LAE group (hazard ratio (HR): 1.81, 95% confidence interval (CI): 1.29-2.57, p<0.01). After adjustment by the components of CHADS2 score and oral anticoagulant prescription, LAE was independently associated with higher risk for stroke/SE (HR: 1.70, 95% CI: 1.20-2.43, p<0.01). This was also the case when we defined cut-off as 40 mm (HR: 1.67, 95% CI: 1.12-2.55, p=0.01), and as 50 mm (HR: 1.58, 95% CI: 1.08-2.29, p=0.02), or we analyzed left atrial diameter as continuous variables (HR (per 1mm): 1.03, 95% CI: 1.01-1.05, p<0.01). Even after adjustment by type of AF (paroxysmal or sustained) and valvular heart diseases, LAE remained to be independently associated with the risk of stroke/SE (HR: 1.57, 95% CI: 1.08-2.31, p=0.02).
Conclusion: Left atrial enlargement was independently associated with the increased risk of stroke/SE in AF patients.
Author Disclosures: Y. Hamatani: None. D. Takagi: None. H. Ogawa: None. M. Esato: None. Y. Chun: None. H. Wada: None. K. Hasegawa: None. M. Abe: None. M. Akao: Research Grant; Modest; Boehringer Ingelheim, Bayer, Daiichi-Sankyo, Takeda Pharmaceutical.. Speakers Bureau; Modest; Pfizer, Daiichi-Sankyo, Tanabe-Mitsubishi.. Speakers Bureau; Significant; Bristol-Myers Squibb, Boehringer Ingelheim, Bayer..
- © 2015 by American Heart Association, Inc.