Echocardiographic Parameters of Left Atrial Structure and Function and Clinical Outcomes at 2 Years in Elderly Patients With Atrial Fibrillation　― The ANAFIE Echocardiographic Substudy ―

1,474 elderly Japanese outpatients (aged >=75 years) with non-valvular atrial fibrillation (NVAF) diagnosed via ECG from the multicenter, prospective ANAFIE Registry who underwent transthoracic echocardiography at baseline or within 2 months after enrollment. Mean age 80.7 years, 59.2% male, mean CHA2DS2-VASc score 4.3, 45.9% paroxysmal AF, 32.2% history of heart failure, 92.7% on oral anticoagulants (68.7% DOAC, 24.0% warfarin). Exclusions: mitral stenosis, artificial heart valve replacement, recent (within 1 month) CV events or hospitalization-requiring bleeding, life expectancy <1 year.

Baseline transthoracic echocardiography evaluating left atrial (LA) structure and function, categorized by abnormal LA emptying fraction (LAEF total <=45.0%, n=1,213) and severely dilated maximum LA volume index (max. LAVi >48.0 mL/m2, n=656).

Preserved/normal echocardiographic LA parameters: LAEF total >45.0% (n=224) and max. LAVi <=48.0 mL/m2 (n=621); also subgroup comparisons of direct oral anticoagulants (DOACs) vs. warfarin.

Clinical outcomes at 2 years including stroke/systemic embolic events (SEE), cardiovascular (CV) events (composite of stroke, MI, cardiac intervention, HF hospitalization, CV death), cardiac events (composite of MI, cardiac intervention, HF hospitalization, and CV death), HF hospitalization, and all-cause death.composite