The predictive role of E/e′ on ischemic stroke and atrial fibrillation in Japanese patients without atrial fibrillation

Abstract

BackgroundThe predictive role of E/e′ on ischemic stroke (IS) and atrial fibrillation (AF) in Japanese patients without AF are unclear. Methods and resultsShinken database includes all the new patients visiting the Cardiovascular Institute Hospital in Tokyo, Japan. E/e′ has been routinely measured since 2007. Patients without AF for whom E/e′ was measured at the initial visit between 2007 and 2014 (n=11 477, mean age 57.2 years old, men 59.5%) were divided into E/e′ tertiles (<8.04, 8.04–11.00, >11.00). During the mean follow-up period of 1.8 years, 58 IS and 140 new appearances of AF were observed. High E/e′ tertile was associated with more prevalence of atherothrombotic risks. The cumulative incidence of IS events and new appearance of AF at 6 years in low, middle, and high E/e′ tertiles were 0.5%, 1.4%, and 3.0%/year (log-rank test, p<0.001), and 2.5%, 2.9%, and 4.2%/year (log-rank test, p=0.007), respectively. In multivariate analysis, high E/e′ tertile was independently associated with IS (HR, 2.857, 95%CI 1.257–6.495, p=0.012). Although high E/e′ tertile was independently associated with new appearance of AF when adjusted for coexistence of atherothrombotic risk factors (HR, 1.694, 95%CI, 1.097–2.616, p=0.017), the association was attenuated after adjustment for left atrial dimension. ConclusionsE/e′ was significantly associated with incidence of IS and new appearance of AF in non-AF patients.