From the Department of Cardiology (Wang, Zeng, Chen), Yongchuan Hospital of Chongqing Medical University; and form the Department of Cardiology (Chen, Yu), The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Saudi Med J. 2023 Dec;44(12):1260-1268. doi: 10.15537/smj.2023.44.12.20230235.
To evaluating the predictive significance of the left atrial diameter in acute ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
The STEMI population came from 2 retrospective cohorts with 1097 patients, cohorts A (YongChuan Hospital) and cohorts B (Taizhou First People's Hospital). Within 3 days (cohort A) or 5 days (cohort B) post-PCI, patients underwent ultrasound evaluations. Cohort A was segmented into quartile categories based on eft atrial diameter (LAd) (Q1 to Q4). The odds ratios (ORs) for overall mortality were assessed using logistic regression. Cohort B was used for sensitivity analysis.
During follow-up period, 226 (20.6%) patients experienced endpoint. In cohort A, univariable odds ratios were 2.68 (95%CI 1.116.89), 5.32 (95%CI 2.4612.83) and 11.92 (95%CI 5.7827.92), while multivariate ORs were 2.25 (95%CI 0.826.55), 5.09 (95%CI 2.1213.56), and 15.05 (95%CI 6.5839.09) in Q2 to Q4 group, respectively, compared with Q1 group (p for trend <0.001). Upon subgroup evaluation, the correlation between LAd and the likelihood of overall mortality was more pronounced in patients having a left ventricular ejection fraction (LVEF) between 40% and 50%, and those with LVEF ≥50%, in contrast to those with LVEF <40% ( for interaction <0.001).
Left atrial diameter is indicative of the long-term overall mortality risk in STEMI patients post-PCI, particularly in those with an LVEF ≥ 40%.
评估左心房直径在接受直接经皮冠状动脉介入治疗（PCI）的急性 ST 段抬高型心肌梗死（STEMI）患者中的预测意义。
STEMI 人群来自两个回顾性队列，共 1097 例患者，队列 A（永川区人民医院）和队列 B（台州市第一人民医院）。在 PCI 后 3 天（队列 A）或 5 天（队列 B）内，患者接受超声评估。队列 A 根据左心房直径（LAd）分为四分之一类别（Q1 至 Q4）。使用 logistic 回归评估全因死亡率的优势比（OR）。队列 B 用于敏感性分析。
在随访期间，226 例（20.6%）患者发生终点事件。在队列 A 中，单变量 OR 分别为 2.68（95%CI 1.116.89）、5.32（95%CI 2.4612.83）和 11.92（95%CI 5.7827.92），而多变量 OR 分别为 2.25（95%CI 0.826.55）、5.09（95%CI 2.1213.56）和 15.05（95%CI 6.5839.09）在 Q2 到 Q4 组，与 Q1 组相比（趋势检验 p<0.001）。亚组评估显示，在左心室射血分数（LVEF）在 40%~50%之间的患者以及 LVEF≥50%的患者中，LAd 与全因死亡率的相关性比 LVEF<40%的患者更为显著（交互检验 p<0.001）。
左心房直径可预测 PCI 后 STEMI 患者的长期全因死亡率，尤其是 LVEF≥40%的患者。
