Left Atrial Volume Index: As a Predictor of Early In-Hospital Major Adverse Cardiovascular Events in Acute Coronary Syndrome

Introduction: Raised Left Atrial Volume Index (LAVI) is considered as an important predictor of poor outcome in patients having acute coronary syndrome. Aim: To study LAVI as a predictor of early in-hospital major cardiovascular events in acute coronary syndrome. Materials and Methods: Prospective observational study was carried out in 84 patients admitted in ICU of tertiary care hospital with a diagnosis of acute coronary syndrome. Clinical, electrocardiogram, 2D echocardiographic, laboratory tests and outcome of patients having acute coronary syndrome during hospital stay were assessed. Biplane method of discs was used to measure Left Atrial Volume (LAV). LAVI was calculated by dividing LAV and body surface area. Out of 84 patients, 26 patients having LAVI >32 mL/m(2) were grouped into group A and 58 patients having LAVI <32 mL/m(2) were grouped into group B. Data were analysed using SPSS software v.23.0. Data was compared between groups using diagrams and significance of data was found by chi-square test. Chi-square (chi(2))/Freeman-Halton Fisher-exact test were employed to determine the significance of differences between groups for categorical data. Results: In group A (26 patients), mean LAVI was 43.2 mL/m(2)+/- 11.2, major adverse cardiovascular events were cardiogenic shock and pulmonary oedema in nine patients (34.6%) each followed by death in five patients (19.2%), heart failure in three patients (11.5%). In group B (58 patients), mean LAVI was 22.9 mL/m(2)+/- 10.9, major adverse cardiovascular events were cardiogenic shock in four patients (6.8%) followed by pulmonary oedema in three patients (5.2%), heart failure in two patients (3.4%) and death in one patient (1.7%). Out of 84 patients, the common wall motion abnormality was anterior wall occurring in 28 patients. There was no significant association between LAVI and wall motion abnormality as p-value was >0.05. Mean ejection fraction was 46.7% in patients with LAVI <32 mL/m(2) (group B) and 37.9% in patients with LAVI >32 mL/m(2) (group A) which was significant, p-value <0.001. Conclusion: Routine measurement of LAV and calculation of LAVI in patients with acute coronary syndrome is necessary to prevent major adverse cardiovascular events.