Left Atrial Volume Index and Prediction of Events in Acute Coronary Syndrome: Solar Registry

Abstract

BackgroundAccording to some international studies, patients with acute coronary syndrome (ACS) and increased left atrial volume index (LAVI) have worse long-term prognosis. However, national Brazilian studies confirming this prediction are still lacking.ObjectiveTo evaluate LAVI as a predictor of major cardiovascular events (MCE) in patients with ACS during a 365-day follow-up.MethodsProspective cohort of 171 patients diagnosed with ACS whose LAVI was calculated within 48 hours after hospital admission. According to LAVI, two groups were categorized: normal LAVI (≤ 32 mL/m2) and increased LAVI (> 32 mL/m2). Both groups were compared regarding clinical and echocardiographic characteristics, in- and out-of-hospital outcomes, and occurrence of ECM in up to 365 days.ResultsIncreased LAVI was observed in 78 patients (45%), and was associated with older age, higher body mass index, hypertension, history of myocardial infarction and previous angioplasty, and lower creatinine clearance and ejection fraction. During hospitalization, acute pulmonary edema was more frequent in patients with increased LAVI (14.1% vs. 4.3%, p = 0.024). After discharge, the occurrence of combined outcome for MCE was higher (p = 0.001) in the group with increased LAVI (26%) as compared to the normal LAVI group (7%) [RR (95% CI) = 3.46 (1.54-7.73) vs. 0.80 (0.69-0.92)]. After Cox regression, increased LAVI increased the probability of MCE (HR = 3.08, 95% CI = 1.28-7.40, p = 0.012).ConclusionIncreased LAVI is an important predictor of MCE in a one-year follow-up.

Prognostic value of left atrial volume index in acute coronary syndrome: A systematic review and meta‐analysis

“…Of 3,184 articles identified in the initial searches, 261 studies were considered as potentially relevant. After stringent selection process, 11 articles met the inclusion criteria (Antoni et al., 2011; Badiger, 2019; Beinart et al., 2004; Cho et al., 2012; Cordeiro et al., 2018; Meris et al., 2009; Moller et al., 2003; Nagula et al., 2020; Sakaguchi et al., 2011; Salehi et al., 2013; Secundo Junior et al., 2014): one was secondary analysis of CTs (Antoni et al., 2011), and remaining 10 papers were observational studies. ( Figure ).…”

Prognostic value of left atrial volume index in acute coronary syndrome: A systematic review and meta-analysis

“…Of 3,184 articles identified in the initial searches, 261 studies were considered as potentially relevant. After stringent selection process, 11 articles met the inclusion criteria (Antoni et al, 2011;Badiger, 2019;Beinart et al, 2004;Cho et al, 2012;Cordeiro et al, 2018;Meris et al, 2009;Moller et al, 2003;Nagula et al, 2020;Sakaguchi et al, 2011;Salehi et al, 2013;Secundo Junior et al, 2014): one was secondary analysis of CTs (Antoni et al, 2011), and remaining 10 papers were observational studies. (Figure S1).…”

Is Indexed Left Atrial Volume (LAVi) in Indian Patients with Acute Coronary Syndrome (ACS) undergoing revascularization a predictor of cardiovascular outcomes?

“…While we found that ~ 60% of 190 patients with ACS had LAVi >32 ml/m 2 , in the Solar registry of patients with ACS ( n = 171), 45% had LAVi >32 ml/m 2 while Gunaskeran et al reported high LAVi values in 32/75 (43%) patients with ACS. [ 16 17 ] In patients with MI, Moller et al [ 9 ] reported that amongst 314 patients with AMI, 45% had LAVi >32 ml/m 2 , and Beinart[ 10 ] observed a high LAVi in 19% of 395 patients with acute MI. In the VALIANT Echocardiography study, Miser et al .…”