Predictive value of left ventricular global longitudinal strain for mid-term major adverse cardiovascular events in patients with atrial fibrillation complicated by acute myocardial infarction.

OBJECTIVE

To investigate the predictive value of left ventricular (LV) global longitudinal strain (GLS) for mid-term major adverse cardiovascular events (MACE) in patients with atrial fibrillation (AF) complicated by acute myocardial infarction (AMI).

METHODS

This single-center cohort study consecutively enrolled 200 patients with AF complicated by AMI, all of whom completed a 12-month follow-up. GLS was measured by two-dimensional speckle-tracking echocardiography within 72 h after admission. Patients were divided into a high-GLS group and a low-GLS group according to the median GLS value. Baseline characteristics and the incidence of mid-term MACE were compared between groups. Cox proportional hazards regression was used to identify factors associated with mid-term MACE. Kaplan–Meier analysis was performed to evaluate differences in event-free survival, and receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of GLS.

RESULTS

Mid-term MACE incidence was higher in the low-GLS group. Age, hyperlipidemia, history of coronary artery disease (CAD), low-density lipoprotein cholesterol (LDL-C), left ventricular end-systolic volume (LVESV), and GLS were significantly associated with the occurrence of mid-term MACE. History of CAD and LDL-C remained independent predictors of mid-term MACE, whereas GLS showed a borderline association after adjustment for LVEF and clinical covariates. Kaplan-Meier survival analysis demonstrated a significantly higher cumulative incidence of mid-term MACE in the low-GLS group. ROC curve analysis indicated that GLS had modest predictive value for mid-term MACE (area under the curve = 0.616).

CONCLUSION

GLS was associated with mid-term MACE and demonstrated incremental predictive value when combined with LVEF, and may provide complementary clinical value for early risk stratification.