P5609 | BEDSIDE LV remodeling caused by persistent atrial fibrillation was associated with high cardiac hyaluronan in coronary sinus vein

Methods: Serum levels of cholesterol-adjusted vitamin E were measured in 1012 patients with non-valvular atrial fibrillation. Patients were followed for a mean time of 27.0 months, and cardiovascular events, such as cardiovascular death and fatal and nonfatal stroke or myocardial infarction, were recorded. Results: During the follow-up period, cardiovascular events occurred in 109 (11%) patients (18 fatal and 14 nonfatal myocardial infarction; 13 fatal and 19 nonfatal ischemic strokes; 45 cardiovascular deaths). Lower vitamin E serum levels were found in patients who experienced cardiovascular events compared to those who did not (3.8±1.2 vs. 4.4±1.8 μmol/mmol cholesterol; p<0.001). Using a Cox proportional hazard model, age, diabetes, history of stroke and myocardial infarction and vitamin E serum levels (HR 0.77; 95% CI: 0.67-0.89; p=0.001) independently predicted cardiovascular events. Patients with vitamin E<4.2 μmol/mmol cholesterol (median values) had an increased risk of cardiovascular events (HR 1.87; 95% CI: 1.25-2.80: p=0.002). Adjusted hazard ratios (HR), based on a Cox proportional Hazards model, of cardiovascular events according to selected variables Variable HR P CI 95% Lower Upper Vitamin E serum levels* 0.773 0.001 0.668 0.894 History of stroke 2.010 0.001 1.323 3.054 History of myocardial infarction 2.677 <0.001 1.814 3.952 Age ≥ 75 years 1.936 0.001 1.319 2.843 Diabetes 1.680 0.017 1.099 2.570 After adjusting for heart failure, total and LDL cholesterol, oral anticoagulants, CrCl, hs-CRP, left atrium diameter (none of these variables was significant). *HR for an increasing unit change in the independent factor. Conclusions: Low vitamin E serum levels are associated with an increased risk of cardiovascular events in patients with non-valvular atrial fibrillation.