Different associations between left atrial size and 2.5-year clinical outcomes in patients with anterior versus non-anterior wall ST-elevation myocardial infarction

Abstract

Objective: To investigate associations between left atrial diameter (LAD) and long-term outcomes in patients with anterior or non-anterior wall ST-elevation myocardial infarction (STEMI). Methods: Patients with STEMI were included in this secondary analysis of data from a prospective cohort study in which the primary outcome was major adverse cardiovascular event (MACE) occurrence during a 2.5-year follow-up. A LAD cutoff value was obtained through receiver operating characteristic curve analysis. Kaplan-Meier curve and Cox regression analyses were applied. Subgroup Cox regression analysis was also performed, with patients stratified based on left ventricular diastolic diameter (LVEDD, > 55 mm and 55 mm). The relationship between LAD and outcomes in patients with anterior or non-anterior wall STEMI was explored using restricted cubic spline functions. Results: Out of 464 patients, adjusted Cox regression showed that dichotomous (>40 mm) LAD was significantly associated with MACE (hazard ratio 2.978, 95% confidence interval 1.763, 5.030) in patients with anterior wall but not non-anterior wall STEMI. The association was not different between normal and enlarged LVEDD groups. Conclusions: A left atrium > 40 mm may indicate higher risk of MACE in patients with anterior wall STEMI, even in patients with normal left ventricular structure. This relationship was not observed in patients with non-anterior wall STEMI.

Novel Biomarkers in Evaluating Cardiac Function in Patients on Hemodialysis—A Pilot Prospective Observational Cohort Study

“…To our knowledge, no studies have evaluated the impact of left atrium diameter on IL-1B levels. Even though left atrium diameter larger than 40 mm is associated with a higher risk of major adverse cardiac events (MACEs) [45], in our study, left atrium diameter did not increase the risk of death.The study of Orn is the only one that evaluated the impact of IL-1B measured after myocardial infarction on left ventricular modeling evaluated through cardiac magnetic resonance at one year after infarction [40]. He showed that increased IL-1B levels at 2 months following myocardial infarction were associated with the left ventricle end systolic index.…”

Development and validation of a nomogram for predicting significant coronary artery stenosis in suspected non-ST-segment elevation acute coronary artery syndrome with low-to-intermediate risk stratification

“…In addition to the parameters mentioned above, an obviously enlarged left atrium (≥39 mm) was also included in the nomogram. The structural changes of the left atrial cavity have been previously linked to the slow flow of coronary arteries since insufficient oxygen supply leads to diastolic dysfunction of the left ventricle and elevates ventricular filling pressure, which subsequently conducted to the left atrium, causing increased atrial wall tension ( 33 , 34 ). The metric LAd obtained from routinely available echocardiograms was simple and stable.…”

Left Atrial diameter Index as a prognostic factor for STEMI: a case-control study

“…Our study shows that EF and LAdI are independent risk factors for MACEs, which is consistent with most current studies. [37,38] Although the American Society of echocardiography recommended to estimate the size of LA with LAV as early as 2005,[6] the complexity of operation limits the application of LAV.…”