Left atrial volume index as a predictor of left ventricular remodeling in patients with anterior STEMI treated with primary PCI

BackgroundLeft ventricular remodeling (LVR) after myocardial infarction (MI) is associated with adverse cardiovascular events. Left atrial volume index (LAVI) was emerged as a prognostic factor for cardiovascular outcome. The aim of the study was to assess the value of measuring LAVI at discharge as a predictive factor for the development of LVR after anterior ST-elevation MI (STEMI) treated with primary percutaneous coronary intervention (PPCI).MethodsThe study included 100 consecutive patients with first anterior STEMI successfully treated with primary percutaneous coronary intervention (PPCI). Echocardiographic evaluation was performed at the time of discharge and at 6 months. LVR was defined as >20% increase in LVEDVI at 6 months compared with that at discharge.ResultsThe prevalence of LVR was 31%. Patients who developed LVR had higher LVESVI at baseline, lower EF%, higher WMSI, higher LAVI, and longer time to perfusion. Multivariable logistic regression analysis showed that LAVI was the only predictive factor for LVR (p = 0.003, 95% CI = 1.87–19.7). ROC curve analysis showed that LAVI was predictive for LVR with a cut-off value 38 ml/m2 (sensitivity 96.8% and specificity 77%, p = 0.001, 95% CI = 0.93–0.99).ConclusionLAVI is a simple and non-invasive echocardiographic marker that can predict the development of LVR in patients with anterior STEMI treated with PPCI.