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Updated: Aug 2, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Impact of left atrial diameter on all-cause mortality of patients with STEMI undergoing primary percutaneous coronary
Kai Wang1, Deli Zeng1, Zijun Chen1
1From 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.
Insights
Left atrial diameter predicts long-term mortality in ST-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). Larger diameters indicate higher risk, especially in those with preserved left ventricular ejection fraction (LVEF) ≥ 40%.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Imaging
Background:
- Acute ST-elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Primary percutaneous coronary intervention (PCI) is a standard treatment for STEMI.
- Predictive markers for long-term outcomes in STEMI patients are crucial for risk stratification.
Purpose of the Study:
- To investigate the predictive value of left atrial diameter (LAd) for overall mortality in STEMI patients.
- To assess the association between LAd and long-term outcomes following primary PCI.
- To explore the influence of left ventricular ejection fraction (LVEF) on this association.
Main Methods:
- Retrospective analysis of 1097 STEMI patients from two cohorts undergoing primary PCI.
- Echocardiographic assessment of LAd within days of PCI.
- Logistic regression analysis to determine odds ratios (ORs) for overall mortality based on LAd quartiles (Q1-Q4), with Q1 as reference.
- Sensitivity analysis using a second cohort and subgroup analysis based on LVEF.
Main Results:
- A total of 226 (20.6%) patients experienced mortality during follow-up.
- In Cohort A, multivariate analysis showed significantly increased ORs for mortality in Q2 (2.25), Q3 (5.09), and Q4 (15.05) compared to Q1 (p for trend <0.001).
- The association between LAd and mortality was stronger in patients with LVEF ≥ 40% (p for interaction <0.001).
Conclusions:
- Left atrial diameter is a significant independent predictor of long-term overall mortality in STEMI patients post-PCI.
- Increased LAd is associated with a substantially higher risk of mortality.
- This predictive significance is particularly pronounced in patients with a left ventricular ejection fraction of 40% or greater.
Objectives:
To evaluating the predictive significance of the left atrial diameter in acute ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
Methods:
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.
Results:
During follow-up period, 226 (20.6%) patients experienced endpoint. In cohort A, univariable odds ratios were 2.68 (95%CI 1.11~6.89), 5.32 (95%CI 2.46~12.83) and 11.92 (95%CI 5.78~27.92), while multivariate ORs were 2.25 (95%CI 0.82~6.55), 5.09 (95%CI 2.12~13.56), and 15.05 (95%CI 6.58~39.09) 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% (p for interaction <0.001).
Conclusion:
Left atrial diameter is indicative of the long-term overall mortality risk in STEMI patients post-PCI, particularly in those with an LVEF ≥ 40%.
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