Key result
An increase in left atrial volume index over 12 months after acute myocardial infarction independently predicted new-onset atrial fibrillation or heart failure hospitalization.
Why the study?
Does left atrial remodeling (change in LAVI) predict new onset atrial fibrillation or heart failure hospitalization in patients with STEMI after primary PCI?
Cohort (n=264)
No
Does left atrial remodeling (change in LAVI) predict new onset atrial fibrillation or heart failure hospitalization in patients with STEMI after primary PCI?
Left atrial remodeling, measured by changes in left atrial volume index at 12 months, is a strong independent predictor of new-onset atrial fibrillation and heart failure hospitalization in patients recovering from STEMI.
Answers are grounded in this paper and cite their sources.
Serial LAVI monitoring may aid post-MI risk stratification; leaves open whether remodeling is a modifiable target.
The purpose of this study is to assess the relationship between left atrial (LA) size and outcome after acute myocardial infarction (AMI) in patients undergoing primary percutaneous coronary intervention (PCI) and to evaluate dynamic changes in LA size during long-term follow-up. Echocardiographic analyses were performed on 253 AMI patients (174 male and 79 female, 65.4 ± 13.7 yr) undergoing PCI. These subjects were studied at baseline and at 12 months. Clinical follow-up were done at 30.8 ± 7.5 months. We assessed LA volume index (LAVI) at AMI-onset and at 12-month. Change of LAVI was an independent predictor of new onset of atrial fibrillation or hospitalization for heart failure (P = 0.002). Subjects who survived the 12-month period displayed an increased LAVI mean of 1.86 ± 4.01 mL/m(2) (from 26.1 ± 8.6 to 28.0 ± 10.1 mL/m(2), P < 0.001). The subject group that displayed an increased LAVI correlated with a low left ventricular ejection fraction, large left ventricle systolic and diastolic dimensions and an enlarged LA size. In conclusion, change of LAVI is useful parameter to predict subsequent adverse cardiac event in AMI patients. Post-AMI echocardiographic evaluation of LAVI provides important prognostic information that is significantly greater than that obtained from clinical and laboratory parameters alone.
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Cho et al. (2012) conducted a cohort in ST-elevation acute myocardial infarction (n=264). Increase in left atrial volume index (LAVI) vs. Decreased left atrial volume index was evaluated on Composite of new onset atrial fibrillation or hospitalization for heart failure (HR 1.216, 95% CI 1.091-1.354, p=<0.001). An increase in left atrial volume index over 12 months after acute myocardial infarction independently predicted new-onset atrial fibrillation or heart failure hospitalization.
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