Left atrial function index predicts poor outcomes in acute myocardial infarction patients treated with percutaneous coronary intervention

Yijin Tang; Siling Peng; Hui-Ling Yao; Zhibin Liu; Liang Zhang; Changqing Zhong; Chang She; Wei Liu; Yi Tang; Qinghua Fu; Yi Zhang

doi:10.3389/fcvm.2023.1043775

Left atrial function index predicts poor outcomes in acute myocardial infarction patients treated with percutaneous coronary intervention

Front Cardiovasc Med. 2023 Sep 1:10:1043775. doi: 10.3389/fcvm.2023.1043775. eCollection 2023.

Authors

Yijin Tang^#¹, Siling Peng^#¹, Hui-Ling Yao², Zhibin Liu¹, Liang Zhang³, Changqing Zhong³, Chang She³, Wei Liu³, Yi Tang³, Qinghua Fu³, Yi Zhang³

Affiliations

¹ Department of Cardiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.
² Department of General Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Hunan Normal University, Changsha, China.
³ Department of Cardiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Clinical Medicine Research Center of Heart Failure of Hunan Province, Hunan Normal University, Changsha, China.

^# Contributed equally.

Abstract

Background and aims: The left atrial function index (LAFI) is an index that combines the left atrial emptying fraction, adjusted left atrial volume and stroke volume. The prognostic value of LAFI in acute myocardial infarction (AMI) patients treated with percutaneous coronary intervention (PCI) is unknown. This study aims to determine whether LAFI predicts prognosis in AMI patients treated with PCI.

Methods: Patients with newly diagnosed AMI who were treated with PCI at Hunan Provincial People's Hospital from March 2020 to October 2021 were prospectively enrolled. All patients underwent transthoracic echocardiography (TTE) at baseline and follow-up. The endpoint events included rehospitalization due to unstable angina, nonfatal myocardial infarction, rehospitalization due to heart failure and cardiovascular death.

Results: A total of 368 patients with AMI (92 women; mean age, 61.45 ± 11.91 years) were studied with a median follow-up of 14 ± 6.58 months. Sixty-nine patients had endpoint events. Patients who presented with events had a significantly lower LAFI than patients without events (34.25 ± 12.86 vs. 48.38 ± 19.42, P < 0.0001). Multivariate Cox analysis demonstrated that LAFI (HR = 0.97 [95% CI: 0.95; 0.99]; P = 0.012) and the Killip classification (HR = 1.51 [95% CI: 1.03; 2.22]; P = 0.034) were independently predictive of endpoint events. Kaplan-Meier survival curves showed that patients with LAFI ≤ 40.17 cm/ml/m² had higher events than patients with LAFI > 40.17 cm/ml/m² (HR = 8.53 [95% CI: 4.74; 15.35]; P < 0.0001).

Conclusion: LAFI is a strong and independent predictor of adverse events and can be used for risk stratification in patients with AMI treated with PCI.

Keywords: acute myocardial infarction; left atrial function index; percutaneous coronary intervention; prognosis; transthoracic echocardiography.

Grants and funding

This work was supported by grants from Scientific research project approved by Hunan Provincial Health Commission (202103012117), Key Project of Hunan Provincial Science and Technology Innovation (2020SK1013), the Science and Technology Innovation Program of Hunan Province (2020SK50922), Renshu Fund project of Hunan Provincial People's Hospital (RS2022A12) and Natural Science Foundation of Hunan Province (2021JJ40294).