左心房容积指数与急性冠脉综合征预后的相关性研究

The study of correlation between left atrial volume index and major adverse cardiovascular events after acute coronary syndrome

目的探讨左心房容积指数(LAVI)与急性冠脉综合征(ACS)患者预后的相关性。方法从2015年12月-2016年6月,连续纳入就诊于新疆医科大学第一附属医院心脏中心临床诊断为急性冠脉综合征的住院患者133例,17例患者确定诊断不能满足本研究诊断标准,5例患者在6个月的随访期间失访,最终将111例住院患者根据超声心动图左心房容积指数分为A组(LAVI≥28 mL/m^2, 57例)和B组(LAVI<28 mL/m^2,54例),分别比较2组患者基线资料、Killip分级、GRACE评分及危险评分、实验室指标、B型利钠肽前体(BNP)、超声心动图参数,对患者进行6个月的随访。结果在6个月的随访期间,A组有39例(68.4%)、B组有16例(29.6%)发生了至少1件主要心脏不良事件(MACEs),2组比较差异有统计学意义(P<0.001)。LAVI与GRACE评分存在较弱的正相关关系(γ=0.263,P<0.05),LAVI随着GRACE评分危险分层的升高逐渐增加,差异有统计学意义(P<0.05)。左心房容积指数与主要心脏事件有显著联系(P=0.013,OR=1.320,OR值的95%区间为1.059～1.645)。结论 LAVI与MACEs的发生有相关性,可能是预测急性冠脉综合征发生主要心脏不良事件的独立危险因素。

Objective To investigate the relationship between left atrial volume index(LAVI) and major adverse cardiovascular events(MACEs) after acute coronary syndrome(ACS). Methods 133 hospitalized patients with acute coronary syndrome were collected, which were admitted to the Cardiac Center of the First Affiliated Hospital of Xinjiang Medical University, from December 2015 to June 2016. In which 17 patients confirmed that did not meet the diagnostic criteria of this study, 5 patients were lost to followed up. 111 patients were finally confirmed and divided into group A(LAVI≥28 mL/m^2, 57 cases) and group B(LAVI<28 mL/m^2, 54 cases) according to echocardiographic left atrial volume index. The baseline data, Killip grade, GRACE score and risk score, laboratory index, B-type natriuretic peptide precursor(BNP), and echocardiographic parameters were compared between two groups, and patients were followed up for 6 months. Results During the 6-month follow-up, 39 cases(68.4%) in group A and 16 cases(29.6%) in group B had at least one major adverse cardiac event(MACEs), with a significant difference(P<0.001). There was a weak positive correlation between LAVI and GRACE score(γ=0.263, P<0.05). LAVI increased gradually with the increase of risk stratification of GRACE score, and the difference was statistically significant(P<0.05). Left atrial volume index was correlated with major cardiac events(P=0.013, OR=1.320, 95% CI=1.059 to 1.645). Conclusion There are strong association between LAVI and MACEs, which may be an independent predictor of major adverse cardiovascular events in patient with acute coronary syndrome.