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Atrial Remodeling After Acute Myocardial Infarction: Associations With Infarction Severity, Coronary Anatomy, and Chronic Cardiovascular Risk Factors
Session:
Sessão de Posters 02 - Síndromes coronárias agudas: vias, atrasos e impacto das recomendações
Speaker:
Benedita Couto Viana
Congress:
CPC 2026
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.1 Acute Coronary Syndromes – Pathophysiology and Mechanisms
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Benedita Couto Viana; Luana Alves
Abstract
<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Introduction:</strong></span></span></span><br /> <span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Atrial remodeling after acute myocardial infarction (AMI) is an important marker of hemodynamic load and cardiovascular risk. This study examined, in first-episode AMI, the structural and biochemical determinants of atrial remodeling over 1 year, using ST-segment elevation status (STEMI/NSTEMI), troponin, Killip class, and left ventricular ejection fraction (LVEF) as indicators of infarction severity, and integrating coronary anatomy and chronic cardiovascular risk factors.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods:</strong></span></span></span><br /> <span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">We included 148 consecutive patients admitted with AMI (2013–2015) to a tertiary CARE center. Left atrial volume index (LAVI) and B-type natriuretic peptide (BNP) were measured at baseline and 12 months. Demographic, clinical, angiographic, and biochemical variables were related to structural and biomarker-based remodeling.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results:</strong></span></span></span><br /> <span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Mean age was 54.5 ± 10.0 years; 87.2% were male; mean BMI was 27.2 ± 3.2 kg/m². Smoking was present in 74%, hypertension in 38.5%, diabetes mellitus in 15.6%, and dyslipidemia in 64.9%. STEMI accounted for 69.6% of cases. The left anterior descending artery (LAD) was involved in 52.4%, the circumflex in 17.0%, and the right coronary artery in 30.6%. Troponin correlated with 12-month LAVI (p = 0.002) and 12-month BNP (p < 0.001). STEMI patients had higher 1-year LAVI (p = 0.042). Higher Killip class was associated with elevated 12-month BNP (p = 0.005), larger 12-month LAVI (p = 0.033), and greater absolute and relative LAVI progression (both p = 0.002). Lower baseline LVEF related to higher 12-month BNP (p = 0.040) and LAVI (p = 0.028). LAD involvement predicted higher 12-month BNP (p = 0.002) and showed a borderline association with higher 12-month LAVI (p = 0.073). Among chronic risk factors, only diabetes mellitus was associated with higher 12-month BNP (p = 0.020) and showed a trend toward greater LAVI progression (p = 0.063).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusions:</strong></span></span></span><br /> <span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Atrial remodeling after first-episode AMI appeared consistently associated with multiple indicators of infarction severity, suggesting hemodynamic burden as a major contributor. Although the circumflex and right coronary arteries supply atrial branches, they showed no associations with remodeling in this cohort. Coronary anatomy therefore seemed to act mainly as a surrogate for infarct extent, particularly regarding LAD involvement. Diabetes mellitus emerged as a potential chronic modifier of the atrial response and warrants further investigation.</span></span></span></p>
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