TITLE

Left atrial size and risk for all-cause mortality and ischemic stroke

AUTHOR(S)
Bouzas-Mosquera, Alberto; Broullón, Francisco J.; Álvarez-García, Nemesio; Méndez, Elizabet; Peteiro, Jesús; Gándara-Sambade, Teresa; Prada, Oscar; Mosquera, Víctor X.; Castro-Beiras, Alfonso
PUB. DATE
July 2011
SOURCE
CMAJ: Canadian Medical Association Journal;7/12/2011, Vol. 183 Issue 10, pE657
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Limited data are available on the relation between left atrial size and outcome among patients referred for clinically indicated echocardiograms. Our aim was to assess the association of left atrial size with all-cause mortality and ischemic stroke in a large cohort of patients referred for echocardiography. Methods: Left atrial diameter was measured in 52 639 patients aged 18 years or older (mean age 61.8 [standard deviation (SD) 16.3] years; 52.9% men) who underwent a first transthoracic echocardiogram for clinical reasons at our institution between April 1990 and March 2008. The outcomes were all-cause mortality and nonfatal ischemic stroke. Results: Based on the criteria of the American Society of Echocardiography, 50.4% of the patients had no left atrial enlargement, whereas 24.5% had mild, 13.3% had moderate and 11.7% had severe left atrial enlargement. Over a mean follow-up period of 5.5 (SD 4.1) years, 12 527 patients died, and 2314 patients had a nonfatal ischemic stroke. Cumulative 10-year survival was 73.7% among patients with normal left atrial size, 62.5% among those with mild enlargement, 54.8% among those with moderate enlargement and 45% among those with severe enlargement (p < 0.001). After adjustment in multivariable Cox proportional hazard analysis, left atrial diameter remained a predictor of all-cause mortality in both sexes (hazard ratio [HR] per 1-cm increment in left atrial size 1.17, 95% confidence interval [CI] 1.12--1.22, p < 0.001 in women, and HR 1.09, 95% CI 1.05--1.13, p < 0.001 in men) and of ischemic stroke in women (HR 1.25, 95% CI 1.14--1.37, p < 0.001). Interpretation: Left atrial diameter has a graded and independent association with all-cause mortality in both sexes and with ischemic stroke in women.
ACCESSION #
64640195

 

Related Articles

  • Increased mortality in patients with conflicting diastolic parameters. Bahrainy, Samira; Vo, Michelle; Gill, Edward // International Journal of Cardiovascular Imaging;Apr2012, Vol. 28 Issue 4, p735 

    The aim of this study was to describe the clinical characteristics and mortality of patients with conflicting diastolic function during follow-up. Up to 30% of patients have conflicting diastolic function by echo Doppler and therefore cannot be classified into a distinct diastolic dysfunction...

  • Long-term association of routine blood count (Coulter) variables on fatal coronary heart disease: 30-year results from the first prospective Northwick Park Heart Study (NPHS-I). Pizzi, Costanza; De Stavola, Bianca L.; Meade, Tom W. // International Journal of Epidemiology;Feb2010, Vol. 39 Issue 1, p256 

    Background: Since evidence of a long-term association between routine blood count (Coulter) variables and coronary heart disease (CHD) is inconsistent, the authors analysed white blood cell count (WBC), red blood cell count (RBC), haemoglobin (Hgb), packed cell volume (PCV) and...

  • Coronary artery calcification is increased in patients with COPD and associated with increased morbidity and mortality. Williams, Michelle C.; Murchison, John T.; Edwards, Lisa D.; Agustí, Alvar; Bakke, Per; Calverley, Peter M. A.; Celli, Bartolome; Coxson, Harvey O.; Crim, Courtney; Lomas, David A.; Miller, Bruce E.; Rennard, Steve; Silverman, Edwin K.; Tal-Singer, Ruth; Vestbo, Jørgen; Wouters, Emiel; Yates, Julie C.; van Beek, Edwin J. R.; Newby, David E.; MacNee, William // Thorax;Aug2014, Vol. 69 Issue 8, p718 

    Background: Coronary artery calcification is pathognomonic of coronary artery disease (CAD). Whether CAD in patients with COPD is linked to lung function, functional capacity and/or clinically relevant outcomes is unknown. The objective was to assess the association between CAD and disease...

  • The opposite associations of long-chain versus very long-chain monounsaturated fatty acids with mortality among patients with coronary artery disease. Zhongxia Li; Yuan Zhang; Dongfang Su; Xiaofei Lv; Min Wang; Ding Ding; Jing Ma; Min Xia; Dongliang Wang; Yan Yang; Jian Qiu; Gang Hu; Wenhua Ling // Heart;Oct2014, Vol. 100 Issue 20, p1597 

    Objective Epidemiological evidence suggests that different lengths of carbon chains might predict cardiovascular disease (CVD) events differently. However, little data exist concerning the effects of specific types of monounsaturated fatty acids (MUFAs) stratified by chain length. Therefore, the...

  • Influence of sex on outcomes after percutaneous coronary intervention in patients over 75 years of age with coronary heart disease. Yuqi Liu; Xin Hu; Qiao Xue; Yusheng Zhao; Yu Wang; Lei Gao // Clinical Interventions in Aging;2014, Vol. 9, p1831 

    Background: This study aimed to investigate whether there were sex differences in in-hospital and long-term outcomes for elderly patients over 75 years of age undergoing percutaneous coronary intervention for coronary heart disease. Methods: Consecutive patients aged ⩾75 years who underwent...

  • Relations of Changes in Coronary Disease Rates and Changes in Risk Factor Levels: Methodological Issues and a Practical Example. Dobson, Annette; Filipiak, Birgit; Kuulasmaa, Kari; Beaglehole, Robert; Stewart, Alistair; Hobbs, Michael; Parsons, Richard; Keil, Ulrich; Greiser, Eberhard; Korhonen, Heikki; Tuomilehto, Jaakko // American Journal of Epidemiology;1996, Vol. 143 Issue 10, p1025 

    One of the main hypotheses of the World Health Organization (WHO) MONICA Project is that trends in the major coronary disease risk factors are related to trends in rates of fatal and non-fatal coronary disease events. The units of study are populations rather than individuals. The WHO MONICA...

  • HbA1c and the Risks for All-Cause and CardiovascularMortality in the General Japanese Population. SAKURAI, MASARU; SAITOH, SHIGEYUKI; MIURA, KATSUYUKI; NAKAGAWA, HIDEAKI; OHNISHI, HIROFUMI; AKASAKA, HIROSHI; KADOTA, AYA; KITA, YOSHIKUNI; HAYAKAWA, TAKEHITO; OHKUBO, TAKAYOSHI; OKAYAMA, AKIRA; OKAMURA, TOMONORI; UESHIMA, HIROTSUGU // Diabetes Care;Nov2013, Vol. 36 Issue 11, p3759 

    OBJECTIVE-Associations between HbA1c and cardiovascular diseases (CVD) have been reported mainly in Western countries. It is not clear whether HbA1c measurements are useful for assessing CVD mortality risk in East Asian populations. RESEARCH DESIGN AND METHODS-The risk for cardiovascular death...

  • Hyperglycemia and Mortality Among Patients With Coronary Artery Disease. Ding Ding; Jian Qiu; Xinrui Li; Dan Li; Min Xia; Zhongxia Li; Dongfang Su; Yujie Wang; Yuan Zhang; Jinxia Zhang; Xiaofei Lv; Yunjun Xiao; Gang Hu; Wenhua Ling // Diabetes Care;Feb2014, Vol. 37 Issue 2, p546 

    OBJECTIVE Known diabetes is an independent predictor for mortality in coronary artery disease (CAD) patients; however, whether other glucose abnormalities are associated with death risk in CAD patients is unclear. The goal of this study was to examine the association between different glucose...

  • Prediction of Mortality Using On-Line, Self-Reported Health Data: Empirical Test of the Realage Score. Hobbs, William R.; Fowler, James H. // PLoS ONE;Jan2014, Vol. 9 Issue 1, p1 

    Objective: We validate an online, personalized mortality risk measure called “RealAge” assigned to 30 million individuals over the past 10 years. Methods: 188,698 RealAge survey respondents were linked to California Department of Public Health death records using a one-way...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics