Abstract 2081: The Effect Of Left Atrial Volume On Prognostic Value Of Dobutamine-atropine Stress Echocardiography In Patients With Suspected Or Known Coronary Artery Disease.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jeane Tsutsui ◽  
Paulo M Dourado ◽  
Sandra N Falcão ◽  
Antonio C Chagas ◽  
Protásio L daLuz ◽  
...  
Keyword(s):  
Left Atrial ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Left Atrial Volume ◽  
Atrial Volume ◽  
Left Atrial Diameter ◽  
End Point ◽  
Major Cardiovascular Events ◽  
Male Sex ◽  
Artery Disease

Although dobutamine-atropine stress echocardiography (DSE) is an established technique for detecting coronary artery disease (CAD), new echocardiographic parameters have been recently described to influence the prognostic value of this test. Objective: To determine the influence of left atrial anatomical evaluation on the prognostic value of DSE in patients with known or suspected CAD. Methods: From January 2000 to October 2004 we studied 981 pts (61±12 years, 536 men) who underwent DSE with early-atropine injection protocol. Primary end-point was major cardiovascular events, defined as non-fatal myocardial infarction (MI) and cardiac death (CD). Secondary end-point was major cardiovascular events plus revascularization (surgical and percutaneous). Left atrial diameter was determined by two-dimensional echocardiography in longitudinal paraesternal view and left atrial volume in apical 4-chamber view, at rest. Abnormal DSE was defined as fixed or inducible wall motion abnormalities. Pts were followed for a mean of 18 months (6 to 47 months). Results: DSE was abnormal in 330(34%) pts. Mean left atrial diameter was 3.9±0.6 cm (2.2±0.4 cm/m2) while mean left atrial volume was 54.4±18.9 ml (30.7±11.2 ml/m2). Major cardiovascular events occurred in 39(4%) pts (29 CD and 10 non-fatal MI). A total of 120(12%) pts achieved secondary end-point. By univariate analysis the predictors of CD or non-fatal MI were left atrial diameter (p=0.0013), left atrial volume (p<0.001), male sex (p=0.007), diabetes mellitus (p=0.013), previous MI (p=0.013), left ventricular ejection fraction (p<0.001), and abnormal DSE (p<0.001). By multivariate analysis, the independent predictors of CD and MI were left atrial volume (RR=1.02; 95%CI =1.01–1.03; p<0.001) and abnormal DSE (RR=6.38; 95%CI =3.1–13.2; p<0.001). When considering secondary end-point, independent predictors of combined events were left atrial volume (RR=1.01; 95%CI =1.01–1.02; p<0.001), male sex (RR=1.7; 95%CI =1.1–2.5; p=0.017), and abnormal DSE (RR=4.4; 95%CI =2.9 – 6.6; p<0.001). Conclusion: Resting left atrial volume is an independent predictor of major cardiovascular events and combined events and can be used as an incremental tool for prognostic evaluation of patients who underwent DSE.

P6448Major cardiovascular events free survival in the long term follow up of “real world” diabetic patients with stable coronary artery disease at the beginning of the 21st century. The CICCOR Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ruiz Ortiz ◽  
J J Sanchez Fernandez ◽  
C Ogayar Luque ◽  
E Romo Penas ◽  
M Delgado Ortega ◽  
...  
Keyword(s):  
Real World ◽  
Cardiovascular Events ◽  
Stable Coronary Artery Disease ◽  
Diabetic Patients ◽  
Free Survival ◽  
End Point ◽  
Major Cardiovascular Events ◽  
Artery Disease

Abstract Background Safety trials of antidiabetic drugs have included a main endpoint of cardiovascular morbidity and mortality. However, “real world” data on long term prognosis of diabetic patients with stable coronary artery disease (sCAD) are limited. This study aimed to assess long-term incidence of major cardiovascular events in this population and to identify clinical predictors of this end-point. Methods The CICCOR registry is a prospective, monocentric, cohort study. From February 1, 2000 to January 31, 2004, all consecutive patients with sCAD attended at two outpatient cardiology clinics in a city of the south of Spain were included in the study and prospectively followed. Patients with type 2 diabetes mellitus were selected for this analysis. None of these patients received sodium-glucose cotransporter-2 inhibitors at first visit, as they were not commercially available at that time. Survival free of major cardiovascular events (combined end-point: acute myocardial infarction, stroke, or cardiovascular death) and variables associated with this end-point were investigated. Results The study sample included 394 patients (mean age 68±9 years, 61% male). After up to 17 years of follow-up (median 9 years, IQR 4–14 years, only 2 patients lost in follow-up, with a total of 3517 patients-years of observation), 66 had an acute myocardial infarction, 55 had an stroke and 165 died for cardiovascular causes. Survival free of major cardiovascular events was 88%, 70%, 57%, 47% and 32% at 3, 6, 9, 12 and 15 years. Multivariate predictors of the combined end-point are shown in the table. Predictors of major cardiovascular event Variable Hazard Ratio (95% CI) p value Age (year) 1.06 (1.04–1.08) <0.0005 Tobacco use 0.02 Never smoker 1 (reference) Ex-smoker 1.43 (1.02–1.99) 0.04 Active smoker 2.23 (1.16–4.30) 0.02 Functional Class ≥II (angina) 1.57 (1.14–2.16) 0.006 Resting heart rate (10 bpm increase) 1.12 (1.01–1.24) 0.04 Diuretic treatment at first visit 1.71 (1.26–2.30) 0.001 Conclusions Probability of major event-free survival was only 47% at 12 years in this “real world” cohort of diabetic patients with sCAD followed in the first 17 years of this century in a single center in the south of Spain. Simple clinical variables can identify patients at higher risk of events. Acknowledgement/Funding This work has been partially financed by an investigational grant by Boehringher Ingelheim

scholarly journals Prognostic value of left atrial volume in patients with dilated cardiomyopathy

2013 ◽  
Vol 32 (11) ◽  
pp. 865-872 ◽  
Author(s):  
Filipa Ferreira ◽  
Ana Galrinho ◽  
Rui Soares ◽  
Luísa Branco ◽  
João Abreu ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Left Atrial ◽  
Prognostic Value ◽  
Left Atrial Volume ◽  
Atrial Volume

Prognostic Value of Left Atrial Volume in Asymptomatic Organic Mitral Regurgitation

2013 ◽  
Vol 26 (7) ◽  
pp. 699-705 ◽  
Author(s):  
Aníbal Arias ◽  
Rodolfo Pizarro ◽  
Pablo Oberti ◽  
Mariano Falconi ◽  
Luciano Lucas ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Atrial ◽  
Prognostic Value ◽  
Left Atrial Volume ◽  
Atrial Volume
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