Heart failure & cardiomyopathies
Association of Coagulation Factor XI Level With Cardiovascular Events and Cardiac Function in Community-Dwelling Adults: From ARIC and CHS
Main finding · Incident HFResult — go to the resultHazard ratio 1.36 95% CI 1.01–1.83Authors' conclusion
Decreased FXI level is associated with greater incidence of HF, especially in older adults. It is also associated with prevalent AF, worse diastolic function, worse LA function, and greater LA size.
Study context
- Population
- Community-dwelling adults attending ARIC visit 5 (2011–2013) with plasma factor XI (FXI) levels and echocardiography; median age 75 years, 57% female, 17% BlackARIC
- Participants
- 4,471 adults
- Exposure
- Lower vs higher plasma FXI level
- Outcome
- Incident HF and AF
- Follow-up
- Median 9 years
Methodological detailsexternal validation in CHS
- External validation in CHS
Main finding
Incident HF
Hazard ratio
1.36
95% CI 1.01–1.83
Per 1-unit decrement of log2-transformed FXI level, as printed
As reported in the abstract
Observational data: associations, not effects.
Further findings
Prevalent atrial fibrillation (AF) (cross-sectional, ARIC visit 5)
| Comparison | OR (95% CI) | |
|---|---|---|
| Lower FXI | 1.96 (1.23–3.07) | |
| 0.20.5125Odds ratio (log scale) |
Incident heart failure (HF), by age (subgroup)
| Comparison | HR (95% CI) | |
|---|---|---|
| Decreased FXI · ≥75 years | 1.57 (1.08–2.28) | |
| Decreased FXI · <75 years | 1.11 (0.68–1.79) | |
| 0.512Hazard ratio (log scale) |
Prevalent AF (cross-sectional, ARIC visit 5)
- Not associated with prevalent HF
Incident HF, validation in CHS (ELISA assay)
- Inverse FXI-HF association validated in CHS
- HR, 1.18 [95% CI, 1.02-1.36]
Incident AF · median follow-up 9 years
- Lower FXI not associated with incident AF
Cardiac function (echocardiography, ARIC visit 5)
- Lower FXI associated with higher prevalence of diastolic dysfunction and worse E/A ratio, left atrial (LA) volume index, LA function and LV mass index
- Not associated with LVEF or global longitudinal strain
Original publication
Summarised from the published abstract; every number is checked against it