title: Left Ventricular Ejection Fraction and Risk of Stroke and Cardiac Events in Heart Failure: Data From the Warfarin Versus Aspirin in Reduced Ejection Fraction Trial.
abstract: In heart failure (HF), left ventricular ejection fraction (LVEF) is inversely associated with mortality and cardiovascular outcomes. Its relationship with stroke is controversial, as is the effect of antithrombotic treatment. We studied the relationship of LVEF with stroke and cardiovascular events in patients with HF and the effect of different antithrombotic treatments.
  
  
  
  In the Warfarin Versus Aspirin in Reduced Ejection Fraction (WARCEF) trial, 2305 patients with systolic HF (LVEF≤35%) and sinus rhythm were randomized to warfarin or aspirin and followed for 3.5±1.8 years. Although no differences between treatments were observed on primary outcome (death, stroke, or intracerebral hemorrhage), warfarin decreased the stroke risk. The present report compares the incidence of stroke and cardiovascular events across different LVEF and treatment subgroups.
  
  
  
  Baseline LVEF was inversely and linearly associated with primary outcome, mortality and its components (sudden and cardiovascular death), and HF hospitalization, but not myocardial infarction. A relationship with stroke was only observed for LVEF of <15% (incidence rates: 2.04 versus 0.95/100 patient-years; P=0.009), which more than doubled the adjusted stroke risk (adjusted hazard ratio, 2.125; 95% CI, 1.182-3.818; P=0.012). In warfarin-treated patients, each 5% LVEF decrement significantly increased the stroke risk (adjusted hazard ratio, 1.346; 95% CI, 1.044-1.737; P=0.022; P value for interaction=0.04).
  
  
  
  In patients with systolic HF and sinus rhythm, LVEF is inversely associated with death and its components, whereas an association with stroke exists for very low LVEF values. An interaction with warfarin treatment on stroke risk may exist.
  
  
  
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00041938.
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.). md42@cumc.columbia.edu.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Min
authors.initials: M
authors.lastname: Qian
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: John L P
authors.initials: JL
authors.lastname: Thompson
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Labovitz
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Mann
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Pullicino
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Freudenberger
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: John R
authors.initials: JR
authors.lastname: Teerlink
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Susan
authors.initials: S
authors.lastname: Graham
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Bruce
authors.initials: B
authors.lastname: Levin
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: J P
authors.initials: JP
authors.lastname: Mohr
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Richard
authors.initials: R
authors.lastname: Buchsbaum
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Conrado J
authors.initials: CJ
authors.lastname: Estol
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Lok
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: From the Division of Cardiology, Department of Medicine (M.R.D.T., S.H.), Department of Biostatistics, Mailman School of Public Health (M.Q., J.L.P.T., B.L., R.B.), and Department of Neurology (J.P.M.), Columbia University Medical Center, New York; Department of Cardiovascular Medicine, University of South Florida, Tampa (A.J.L.); Cardiovascular Division, Department of Medicine, Washington University, St. Louis, MO (D.L.M.); Departments of Neurology, Epidemiology and Public Health, University of Miami, FL (R.L.S.); Kent Institute of Medicine and Health Science, Canterbury, United Kingdom (P.M.P.); Division of Cardiology, Department of Medicine, Lehigh Valley Hospital, Allentown, PA (R.S.F.); Section of Cardiology, San Francisco Veterans Affairs Medical Center, University of California San Francisco (J.R.T.); Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Buffalo, NY (S.G.); University of Birmingham Centre for Cardiovascular Sciences, City Hospital, United Kingdom (G.Y.H.L.); Centro Neurológico de Tratamiento y Rehabilitación, Buenos Aires, Argentina (C.J.E.); Department of Cardiology, Deventer Hospital, The Netherlands (D.J.L.); Department of Heart Diseases, Wroclaw Medical University, Military Hospital, Poland (P.P.); and Department of Innovative Clinical Trials, University Medicine Göttingen (UMG), Germany (S.D.A.).
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D014859:Warfarin; D001241:Aspirin
keywords: aspirin; echocardiography; heart failure; heart ventricles; stroke; warfarin