The Role of LAVI/a’ And E/e’ as The Predictors of Major Cardiac Events in ST-Elevation Acute Myocardial Infarction Patients Who Underwent Percutaneous Coronary Intervention

Background: The risk of adverse cardiovascular events remains substantial and may vary significantly among STEMI patients. Echocardiography is the recommended diagnostic tool in predicting outcomes. This study purposed to assess the prognostic role of the combination of LAVI/a’ ratio and E/e’ in STEMI patients who received percutaneous coronary intervention (PCI). Objectives: This study aims to investigated the role of LAVI/a‘ And E/e’as predictors of major cardiac event in St-Elevation acute myocardial infraction who underwent Percutaneous coronary intervention Methods: We conducted a retrospective cohort study in Saiful Anwar General Hospital from 2019 to 2020. All STEMI patients who received PCI were registered. Echocardiography examination was conducted within 24-48 hours after admission. The measurements included LVEF, E/A, E/e’, LAVI/a’, and LV diastolic function according to ASE/EACVI guidelines. All of the patients were given standard medical treatment. Patients who did not comply with the treatment regimen were excluded. The outcome measured was the major adverse cardiovascular events (MACE) within 6-month follow-up period. Results: This study involved 130 patients with a mean age was 61.48 ± 7 years. About 78% of them were male. The receiver operating characteristics (ROC) curve demonstrated that LAVI/a’ ≥4.0 (AUC 0.892, 95% CI 0.819-0.965) and E/e’ ≥13.4 (AUC 0.874, 95% CI; 0.806-0.942) predicted MACE. MACE in 6 months with LAVI/a’ ≥ 4.0 was 40%, E/e’ ≥13.4 was 20%, and the combination of LAVI/a’ ≥4.0 + E/e’ ≥ 13.4 was 60%. Prediction of MACE using LAVI/a’ ≥4.0 had 92% sensitivity and 88% specificity, while E/e’ >13.4 had 80% sensitivity and 74% specificity (CI 95%) and the combination o LAVI/a’ ≥4.0 + E/e’ ≥13.4 had 92% sensitivity and 88% specificity (CI 95%). Conclusion: LAVI/A’ ratio is a promising supporting parameter in predicting MACE, particularly in STEMI patients who received PCI.