Correlation between left atrial spontaneous echocardiographic contrast and 5-year stroke/death in patients with non-valvular atrial fibrillation.


Journal

Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655

Informations de publication

Date de publication:
Historique:
received: 26 11 2019
revised: 17 02 2020
accepted: 18 02 2020
pubmed: 3 9 2020
medline: 30 9 2020
entrez: 3 9 2020
Statut: ppublish

Résumé

Transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) can be used to detect the presence of left atrial thrombus and left atrial spontaneous echocardiographic contrast (LASEC). To evaluate the prognostic value of TTE and TOE in predicting stroke and all-cause death at 5-year follow-up in patients with non-valvular atrial fibrillation (NVAF). This study included patients hospitalised with electrocardiography-diagnosed NVAF in Saint-Antoine University Hospital, Paris, between July 1998 and December 2011, who underwent TTE and TOE evaluation within 24hours of admission. Cox proportional-hazards models were used to identify predictors of the composite outcome (stroke or all-cause death). During 5 years of follow-up, stroke/death occurred in 185/903 patients (20.5%). By multivariable analysis, independent predictors of stroke/death were CHA In this retrospective monocentric study, the presence of moderate/severe LASEC was an independent predictor of stroke/death at 5-year follow-up in patients with NVAF. The inclusion of LASEC in stroke risk scores could modestly improve risk stratification.

Sections du résumé

BACKGROUND BACKGROUND
Transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) can be used to detect the presence of left atrial thrombus and left atrial spontaneous echocardiographic contrast (LASEC).
AIM OBJECTIVE
To evaluate the prognostic value of TTE and TOE in predicting stroke and all-cause death at 5-year follow-up in patients with non-valvular atrial fibrillation (NVAF).
METHODS METHODS
This study included patients hospitalised with electrocardiography-diagnosed NVAF in Saint-Antoine University Hospital, Paris, between July 1998 and December 2011, who underwent TTE and TOE evaluation within 24hours of admission. Cox proportional-hazards models were used to identify predictors of the composite outcome (stroke or all-cause death).
RESULTS RESULTS
During 5 years of follow-up, stroke/death occurred in 185/903 patients (20.5%). By multivariable analysis, independent predictors of stroke/death were CHA
CONCLUSIONS CONCLUSIONS
In this retrospective monocentric study, the presence of moderate/severe LASEC was an independent predictor of stroke/death at 5-year follow-up in patients with NVAF. The inclusion of LASEC in stroke risk scores could modestly improve risk stratification.

Identifiants

pubmed: 32873521
pii: S1875-2136(20)30123-6
doi: 10.1016/j.acvd.2020.02.003
pii:
doi:

Substances chimiques

Anti-Arrhythmia Agents 0
Anticoagulants 0
Platelet Aggregation Inhibitors 0

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

525-533

Informations de copyright

Copyright © 2020. Published by Elsevier Masson SAS.

Auteurs

Laurie Soulat-Dufour (L)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France; INSERM UMRS-ICAN 1166, "Unité de recherche sur les maladies cardiovasculaires, du métabolisme et de la nutrition", 75013 Paris, France.

Sylvie Lang (S)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France.

Arnaud Etienney (A)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France.

Stephane Ederhy (S)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France; INSERM UMRS-ICAN 1166, "Unité de recherche sur les maladies cardiovasculaires, du métabolisme et de la nutrition", 75013 Paris, France.

Yann Ancedy (Y)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France.

Saroumadi Adavane (S)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France.

Marion Chauvet-Droit (M)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France.

Pascal Nhan (P)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France.

Emanuele Di Angelantonio (E)

Department of Public Health & Primary Care, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, United Kingdom.

Franck Boccara (F)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France; INSERM, UMR S 938, Centre de Recherche Saint-Antoine, 75012 Paris, France.

Ariel Cohen (A)

Service de Cardiologie, Hôpitaux Saint-Antoine and Tenon, AP-HP, 75012 Paris, France; INSERM UMRS-ICAN 1166, "Unité de recherche sur les maladies cardiovasculaires, du métabolisme et de la nutrition", 75013 Paris, France. Electronic address: ariel.cohen@aphp.fr.

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