Role of Left Atrial Volume Index and C Reactive Protein /Albumin Ratio as Predictors of New Onset Arrhythmias in ST-Elevation Myocardial Infarction Patients Treated with Percutaneous Coronary Interventions | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 28 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.418316.4136 | ||
| Authors | ||
| Mohammed Mostafa El-Daydamony1; Marwa Mohammed Gad1; Heba Ibrahim Abdelkader Falah* 2; Ahmed S. ElDamanhory3 | ||
| 1Professor of Cardiology department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt | ||
| 3Assistant Professor of Cardiology department, Faculty of Medicine, Zagazig University, Egypt | ||
| Abstract | ||
| Background: Patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) frequently experience new-onset arrhythmias, which are associated with worse outcomes. Two new indicators of arrhythmia risk are left atrial volume index (LAVI),C-reactive protein-to-albumin ratio (CAR). Their prognostic value in STEMI patients after PCI was assessed in this study. Methods: This prospective cohort study, a total of 80 consecutive patients were diagnosed with ST-elevation myocardial infarction (STEMI) were enrolled at Zagazig University Hospitals. Based on the occurrence of arrhythmias during hospitalization, patients were classified into two groups: Group I (arrhythmia group; n=35) and Group II (non-arrhythmia group; n=45). All patients underwent LAVI, which was calculated using standard techniques and indexed to body surface area (BSA). Additionally, C-reactive protein to albumin ratio (CAR) was calculated using CRP and serum albumin levels obtained upon admission, to assess systemic inflammation nutritional status. Results: Arrhythmia occurred in 35 patients (43%). LAVI, CAR were significantly higher in arrhythmia group than in non-arrhythmia group (37.1±5.6vs. 29.7±6.3mL/m², median 6.7vs. 2.7; both p<0.001). New-onset arrhythmia occurred in 35 of 80 patients (43.7%). In multivariable analysis, only heart failure independently predicted arrhythmia (adjusted OR 7.23; 95 % CI 2.29–22.84; p = 0.001). ROC analysis showed that left atrial volume index (AUC 0.81; sensitivity 71 %, specificity 82 %, CRP/albumin ratio (AUC 0.81; sensitivity 70 %, specificity 81 %, were strongest individual predictors). Conclusion: LAVI and CAR demonstrated good discriminative ability for predicting in-hospital arrhythmia after STEMI; however, only heart failure remained an independent predictor after multivariable adjustment. | ||
| Keywords | ||
| ST-segment elevation myocardial infarction; PCI; left atrial volume index; CRP/albumin ratio; Arrhythmia | ||
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