Prognostic Significance of Left Atrial Volume Index in Patients with Acute Coronary Syndrome

Abstract

Background: Patients with acute coronary syndrome (ACS) and increased left atrial volume index (LAVI) have worse long-term prognosis. The present study was designed to evaluate the association between LAVI and the clinical characteristics of the patients with ACS at admission and at follow-up. Materials and Methods: A prospective cohort study was conducted at a tertiary care center in India between April 2018 and December 2019. A total of 80 patients (aged >18 years) having chest pain or its equivalent with a diagnosis of ACS were enrolled as the case group and 30 healthy controls (aged >18 years) were enrolled as the control group. The case group was further classified into two groups based on LAVI values (i.e., LAVI <31 mL/m2 and LAVI ≥31 mL/m2). Baseline demographics, clinical characteristics, and echocardiographic characteristics were recorded of all the patients at admission. The patients were followed up at 1 month and 6 months. Results: The mean age of the case group was 54.7 ± 11.6 years and males were predominant (78.8%). Mean LAVI was 31.1 ± 9.0 mL/m2 in the case group and 24.2 ± 3.1 mL/m2 in the control group. Grade II (30%) and Grade III diastolic dysfunction (30%) were predominant in patients with LAVI ≥31 mL/m2. At 1-month follow-up, mortality was reported in 2 (5%) patients with LAVI <31 mL/m2 and in 5 (12.5%) patients with LAVI ≥31 mL/m2, whereas there was no mortality at 6-months follow-up. A positive correlation was observed between LAVI and E/e’ (P = 0.001), left ventricular end-diastolic diameter (P = 0.001), and left ventricular end-systolic diameter (P = 0.001). The area under the curve for detection of mortality based on LAVI values was 0.776 (95% confidence interval of 0.692–0.860; P = 0.001). Conclusion: The present study demonstrated that LAVI acts as a prognostic marker of adverse events and mortality in patients with ACS.