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Left atrial size is a predictor of all-cause mortality in African Americans, researchers report in the October issue of Stroke.

Left atrial size is a predictor of all-cause mortality in African Americans, researchers report in the October issue of Stroke.

Dr. Ervin R. Fox and colleagues at the University of Mississippi Medical Center, Jackson, note that despite the disproportionately higher rates of stroke and cardiovascular mortality in African Americans compared to non-Hispanic whites, such relationships have not been well characterized.

To investigate further, the researchers studied data on more than 1800 African American participants in an atherosclerosis study and found that subjects in the highest quintile of left atrial diameter/height (2.57 to 3.55 cm/m) were more likely to be female, hypertensive, diabetic and obese.

Over a median follow-up of nearly ten years, there were 106 strokes and 242 deaths. After adjustment for traditional clinical risk factors, those in the highest quintile were at significantly increased risk of stoke (hazard ratio, 1.7) and all-cause mortality (hazard ratio, 2.0).

The link between the top quintile and all-cause mortality persisted after adjustment for hypertrophy and low left ventricular ejection fraction, although the relationship was attenuated.

"Our findings," the researchers conclude, "support the concept that left atrial size may serve as a significant and useful clinical predictor."

Stroke 2008;39:2701-2706