title: Left atrial volume index is an independent predictor of major adverse cardiovascular events in acute coronary syndrome.
abstract: BACKGROUND
  Left atrial volume index (LAVI) is well proven to be a reliable method of determining left atrial size, which has prognostic implications in cardiovascular diseases. Studies demonstrate that increased LAVI is a predictor of mortality in myocardial infarction, but its association with other major adverse cardiovascular events (MACEs) among patients post acute coronary syndrome (ACS) has not been adequately evaluated.
  
  
  METHODS
  We calculated the baseline LAVI for all patients who were admitted with ACS between December 2010 and August 2011. The patients were stratified into 2 arms: normal LAVI and increased LAVI, with a cutoff value of 28 mL/m(2). All patients were prospectively followed up during 6 months for development of MACEs.
  
  
  RESULTS
  Of the 75 patients who completed the study, 32 had increased LAVI, and 43 had normal LAVI. More than half (55%) of the patients were diagnosed with unstable angina. During the follow-up period of 6 months, 30 patients (93.8%) in the increased-LAVI arm and 23 patients (53.5%) in the normal-LAVI arm developed at least a single MACE. Patients with increased LAVI had significantly more MACEs (P = 0.021). The occurrence of MACE remained significantly higher in the increased-LAVI group even when atrial fibrillation was excluded (P = 0.016). After adjusting for confounding variables by multivariate analysis, LAVI was found to have a significant association with MACEs (P = 0.030, odds ratio = 1.229 (95% confidence interval, 1.020-1.481).
  
  
  CONCLUSIONS
  LAVI is a useful tool for prognostication and an independent predictor of MACEs post ACS.
authors.affiliation: Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Ramsamy
authors.initials: R
authors.lastname: Gunasekaran
authors.forename: Oteh
authors.initials: O
authors.lastname: Maskon
authors.forename: Hamat H Che
authors.initials: HH
authors.lastname: Hassan
authors.forename: Nazarudin
authors.initials: N
authors.lastname: Safian
authors.forename: Rajalingham
authors.initials: R
authors.lastname: Sakthiswary
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology; D002306:Cardiac Volume; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis