Purpose: Evaluate if the presence of left atrial (LA) enlargement (LAE) in the acute phase of ACS was associated with MACCE and/or HF during follow-up.
Methods: Retrospective evaluation of 92 consecutive pts admitted to our center due to ACS, with a follow up of 2 years. Echocardiographic parameters of diastolic function (performed during the first 48h after admission) and clinical data were evaluated. LAE was defined as a body surface area indexed LA volume (ILAV) > 34 ml/m2. MACCE was defined as the composite of death, ACS, stroke, repeat revascularization (RR) and congestive heart failure requiring hospitalization (CHF) after hospital discharge.
Results: Mean age was 64.6±12.3 years, with a male predominance (73.9%). At the end of follow-up, 44.9% of pts were at NYHA class = 2. These pts had significantly higher ILAV (35.60 vs 29.46 ml/m2; p=0.040) and on univariate analysis, LAE was the only significant predictor of this outcome (OR 4.22; 95% CI 1.67-10.66; p=0.002), while other classic echocardiographic parameters of diastolic function were not (peak E, A and e’ wave velocities; E/A and E/e’ ratios). During follow-up, MACCE occurred in 18 pts (19.6%): death in 6 (6.5%), ACS in 7 (7.6%), RR in 5 (5.4%) and CHF in 4 (4.3%). LAE was associated with significantly higher risk for MACCE (29.3% vs 6.7%; p=0.006; OR 5.79) and on univariate analysis it was a significant predictor of these events (OR 5.79.; 95% CI 1.50-22.36; p=0.011), with an area under the ROC curve of 0.70 (95% CI 0.56-0.84; p=0.018).
Conclusions: The detection of LAE during the acute phase of ACS was a significant predictor of MACCE and HF during the follow-up, while other parameters of diastolic function weren’t capable to do so.