Trial reportESC heart failure2018
Left atrial volume and cardiovascular outcomes in systolic heart failure: effect of antithrombotic treatment.
Trial report in ESC heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 32 citations in OpenAlex.
- Left atrial volume and cardiovascular outcomes in systolic heart failure: effect of antithrombotic treatment.ESC heart failure · 2018Trial
- Clinical characteristics, antithrombotic strategies, and outcomes in patients with atrial fibrillation and coronary heart disease undergoing percutaneous coronary intervention: a multicenter real-world study in Chongqing, China.BMC cardiovascular disorders · 2026Observational
- Transcatheter edge-to-edge repair vs medical therapy in atrial functional mitral regurgitation: a propensity score-based comparison from the OCEAN-Mitral and REVEAL-AFMR registries.European heart journal · 2026Article
- Combined Catheter Ablation and Left Atrial Appendage Occlusion in Atrial Fibrillation: From Data to Clinical Reality.Cardiovascular drugs and therapy · 2026Review
- Does anticoagulation therapy improve outcomes in severe heart failure with reduced ejection fraction? A systematic review: Anticoagulation in severe heart failure: a systematic review.Annals of medicine and surgery (2012) · 2025Article
- The Predictive Value of Circulating Gal-3 for New Stroke Events in Paroxysmal Atrial Fibrillation Patients Despite Oral Anticoagulation Medications.Clinical cardiology · 2025Article
- Hypertensive Heart Disease: A Narrative Review Series-Part 2: Macrostructural and Functional Abnormalities.Journal of clinical medicine · 2023Review
- Heart Failure with Reduced Ejection Fraction: The Role of Cardiovascular and Lung Ultrasound beyond Ejection Fraction.Diagnostics (Basel, Switzerland) · 2023Review
- Difference of cardiac rehabilitation in the morning or evening on indexes of left ventricular andAnnals of medicine and surgery (2012) · 2023Article
- Left atrial CT volume and CHAScientific reports · 2023Article
- Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction.Journal of cardiovascular development and disease · 2022Article
- The effect of different preoperative left atrial appendage emptying speeds on left atrial function in patients with persistent atrial fibrillation after left atrial appendage closure combined with catheter ablation.BMC cardiovascular disorders · 2022Article
- Left atrial reverse remodeling improves risk stratification in patients with heart failure with recovered ejection fraction.Scientific reports · 2022Article
- Clinical Relevance of the LVEDD and LVESD Trajectories in HF Patients With LVEF < 35.Frontiers in medicine · 2022Article
- Predictors of functional mitral regurgitation recurrence after percutaneous mitral valve repair.Heart and vessels · 2021Article
- Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation.Journal of arrhythmia · 2021Article
- Compressed sensing acceleration of cardiac cine imaging allows reliable and reproducible assessment of volumetric and functional parameters of the left and right atrium.European radiology · 2021Article
- Correlation Between CHAFrontiers in cardiovascular medicine · 2021Article
- Basic and advanced echocardiography in advanced heart failure: an overview.Heart failure reviews · 2020Review
- Comparisons of Left Atrial Functional Parameters with Left Ventricular Diastolic Dysfunction in a Large Taiwanese Population with Normal Left Ventricular Ejection Fraction According to Age.Acta Cardiologica Sinica · 2020Article
Corrections and comments
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Authors and funding
20 authors at 13 institutions in 6 countries.
Funding
Abstract
aimsLeft atrium (LA) dilation is associated with adverse cardiovascular (CV) outcomes. Blood stasis, thrombus formation and atrial fibrillation may occur, especially in heart failure (HF) patients. It is not known whether preventive antithrombotic treatment may decrease the incidence of CV events in HF patients with LA enlargement. We investigated the relationship between LA enlargement and CV outcomes in HF patients and the effect of different antithrombotic treatments. METHODS AND
resultsTwo-dimensional echocardiography with LA volume index (LAVi) measurement was performed in 1148 patients with systolic HF from the Warfarin versus Aspirin in Reduced Ejection Fraction (WARCEF) trial. Patients were randomized to warfarin or aspirin and followed for 3.4 ± 1.7 years. While the primary aim of the trial was a composite of ischaemic stroke, death, and intracerebral haemorrhage, the present report focuses on the individual CV events, whose incidence was compared across different LAVi and treatment subgroups. After adjustment for demographics and clinical covariates, moderate or severe LA enlargement was significantly associated with total death (hazard ratio 1.6 and 2.7, respectively), CV death (HR 1.7 and 3.3), and HF hospitalization (HR 2.3 and 2.6) but not myocardial infarction (HR 1.0 and 1.4) or ischaemic stroke (1.1 and 1.5). The increased risk was observed in both patients treated with warfarin or aspirin. In warfarin-treated patients, a time in therapeutic range >60% was associated with lower event rates, and an interaction between LAVi and time in therapeutic range was observed for death (P = 0.034).
conclusionsIn patients with systolic HF, moderate or severe LA enlargement is associated with death and HF hospitalization despite treatment with antithrombotic medications. The possibility that achieving a more consistent therapeutic level of anticoagulation may decrease the risk of death requires further investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.