Abstract 13961: Prognostic Importance of Increased Left Atrium Volume in Patients with Coronary Chronic Total Occlusion
Background: Recently, left atrium (LA) volume is considered as a powerful predictor of a broad range of cardiovascular diseases. However, its role for mid-term prognosis of percutaneous coronary intervention (PCI) of chronic total coronary occlusion (CTO) is still unknown.
Methods: One hundred forty-one consecutive patients who gave initially successful drug-eluting stent implantation for CTO lesions were enrolled. A CTO was defined as a complete occlusion of a major epicardial coronary artery existing for at least three months. Before procedure, left ventricular (LV) systolic and diastolic variables and LA volume were measured by transthoracic echocardiography. The LA volume was corrected for body surface area. Primary study end-point was major adverse cardiac events (MACE). Patients were divided according to the event-free survival.
Results: During follow-up of 311 days, 108 patients (77%) were angiographically followed. Five patients (4.6%) died, 1 patient (0.9%) admitted for congestive heart failure and 18 (16.7%) needed target lesion revascularization. LA volume index was higher in event group than in event-free group (mean 50 vs. 41 mL/m2, P=0.005). LA volume index was a powerful predictor and remained an independent predictor (hazard ratio: −0.009, P=0.002) after adjustment for clinical factors, LV systolic function, and Doppler-derived variables of diastolic function.
Conclusion: Increased LA volume may be a powerful and independent predictor of MACE after CTO-PCI, and provides prognostic information incremental to clinical data and conventional indices of LV systolic and diastolic function. Measurement of LA volume could emerge as a simple and important tool for risk stratification and as a guide for future surveillance and therapy in patients with successful CTO-PCI.
- © 2010 by American Heart Association, Inc.