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Prognostic Usefulne...
Prognostic Usefulness of Left Ventricular Hypertrophy by Electrocardiography in Patients With Atrial Fibrillation (from the Randomized Evaluation of Long-Term Anticoagulant Therapy Study)
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Verdecchia, Paolo (författare)
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Reboldi, Gianpaolo (författare)
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Di Pasquale, Giuseppe (författare)
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Mazzotta, Giovanni (författare)
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Ambrosio, Giuseppe (författare)
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Yang, Sean (författare)
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Pogue, Janice (författare)
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- Wallentin, Lars (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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Ezekowitz, Michael D. (författare)
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Connolly, Stuart J. (författare)
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Yusuf, Salim (författare)
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(creator_code:org_t)
- Elsevier BV, 2014
- 2014
- Engelska.
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Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 113:4, s. 669-675
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- It is unknown whether left ventricular hypertrophy (LVH) diagnosis by electrocardiography improves risk stratification in patients with atrial fibrillation (AF). We investigated the prognostic impact of LVH diagnosis by electrocardiography in a large sample of anticoagulated patients with AF included in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Study. We defined electrographic LVH (ECG-LVH) by strain pattern or Cornell voltage (R wave in aVL plus S wave in V-3) >2.0 mV (women) or >2.4 mV (men). LVH prevalence was 22.7%. During a median follow-up of 2.0 years, 303 patients developed a stroke, 778 died (497 from cardiovascular causes), and 140 developed a myocardial infarction. LVH was associated with a greater risk of stroke (1.99% vs 1.32% per year, hazard ratio [BR] 1.51, 95% confidence interval [CI] 1.18 to 1.93, p <0.001), cardiovascular death (4.52% vs 1.80% per year, HR 2.56, 95% CI 2.14 to 3.06, p <0.0001), all-cause death (6.03% vs 3.11% per year, HR 1.95, 95% CI 1.68 to 2.26, p <0.0001), and myocardial infarction (1.11% vs 0.55% per year, HR 2.07, 95% CI 1.47 to 2.92, p <0.0001). In multivariate analysis, the prognostic value of LVH was additive to CHA(2)DS(2)-VASc score and other covariates. The category-free net reclassification index and integrated discrimination improvement increased significantly after adding LVH to multivariate models. In conclusion, our study demonstrates for the first time that ECG-LVH, a simple and easily accessible prognostic indicator, improves risk stratification in anticoagulated patients with AF.
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- Av författaren/redakt...
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Verdecchia, Paol ...
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Reboldi, Gianpao ...
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Di Pasquale, Giu ...
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Mazzotta, Giovan ...
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Ambrosio, Giusep ...
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Yang, Sean
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visa fler...
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Pogue, Janice
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Wallentin, Lars
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Ezekowitz, Micha ...
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Connolly, Stuart ...
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Yusuf, Salim
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visa färre...
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American Journal ...
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Uppsala universitet