A Study of Left Atrial Volume Index as a Predictor of Early In-Hospital Major Adverse Cardiovascular Events in Acute Coronary Syndrome
Background: To study left atrial volume index (LAVI) as a predictor of early in-hospital major adverse cardiovascular events in acute coronary syndrome. Materials and Methods: Prospective observational study carried out in 84 patients admitted in ICU of tertiary care hospital with a diagnosis of acute coronary syndrome. Clinical, echocardiographic, laboratory profile and in-hospital outcome of patients with acute coronary syndrome were assessed as a part of study. Left atrial volume was measured using biplane method of discs within 24 hours of admission and left atrial volume index was calculated by dividing left atrial volume and body surface area. Patients were grouped into group A and group B. Patients with LAVI>32ml/m2 were grouped into group A and patients with LAVI<32ml/m2 were grouped into group B. Results: Out of 84 patients, 58 patients having LAVI>32ml/m2 were grouped into group A and 26 patients having LAVI<32ml/m2 were grouped into group B. Out of 26 patients in group A, male patients were 16(61.5%) and female patients were 10(38.5%) and out of 58 patients in group B, male patients were 35(60.7%) and female patients were 23(39.3%). In group A, common risk factors were hypertension in 8 patients (30.7%), smoking in 7 patients (26.9%) and in group B common risk factors were, tobacco chewing in 15 patients(25.8%), hypertension in 14 patients(24.1%). In group A most commonly there was anteroseptal wall hypokinesia in 8 patients (30.7%), left ventricular ejection fraction was 37.9%±5.1 and in group B most commonly there was anteriolateral wall hypokinesia in 16 patients (27.5%), left ventricular ejection fraction was 46.7%±5.9. In group A, major adverse cardiac events were cardiogenic shock in 4 patients (6.8%), pulmonary edema in 3 patients(5.2%), heart failure in 2 patients(3.4%) and death in 1 patient(1.7%) and in group B, major adverse cardiac events were cardiogenic shock in 9 patients (34.6%), pulmonary edema in 6 patients(23%), heart failure in 3 patients(11.5%) and death in 5 patient(19.2%). Conclusion: Group A having LAVI>32ml/m2, was found to be an important predictor of in-hospital major adverse cardiac events.