Parameter Left Atrioventricular Coupling Index Sebagai Prediktor Kejadian Klinis Kardiovaskular Mayor pada Pasien Gagal Jantung Kronis di Rumah Sakit Adam Malik Medan.

Abstract

Background: Chronic heart failure (CHF) is a leading cause of death worldwide. The hemodynamic parameter left atrioventricular coupling index (LACI) captures the chronic pressure-volume relationship, predicts the development of subclinical and advanced disease, and provides a more integrated measure of cardiac function. This study aims to determine LACI parameter as a predictor of major cardiovascular clinical events in CHF patients at Adam Malik Hospital Medan.

Methods: This study was an analytical study with a case control design (retrospective) conducted at Adam Malik Hospital Medan. Patients with a diagnosis of CHF who met the inclusion and exclusion criteria were recruited for the study. The results of echocardiography and LACI examinations were recorded. The study sample was divided into groups with and without major cardiovascular events. The results of the study were recorded and then analyzed. Data were analyzed descriptively and were said to be significant if p <0.05.

Results: The LACI threshold value of 6.35 had a sensitivity of 65% and a specificity of 70% for predicting major cardiovascular clinical events, in cases of CHF (P = 0.0001 AUC 0.736, and 95% CI 0.642 - 0.829). LACI parameter was an independent predictor factor for the occurrence of major cardiovascular clinical events (P = 0.0001; Exp B = 5.382; 95% CI = 2.304 - 12.568). The mean LACI value in patients with major cardiovascular clinical events (7.29 ± 2.25) was higher than those without (5.56 ± 1.71) (P = 0.0001). The prevalence of major cardiovascular clinical events at 1-year follow-up was 28.6%.

Conclusion: LACI parameters are independent predictor factors for the occurrence of major cardiovascular clinical events in cases of CHF.