The association of left atrial volume index and coronary artery disease in type 2 diabetic patients without a history of hypertension and valvular heart disease
Abstract
Background
Left atrial volume index (LAVI) evaluated using echocardiography serves a powerful predictor of cardiovascular outcomes. Since type 2 diabetes mellitus (T2DM) is a main risk factor for coronary artery disease (CAD), the present investigation was conducted to examine the association between LAVI and incidence of CAD in diabetic patients.
Methods
In this case-control study, 90 type 2 diabetic patients aged 18–70 years who underwent coronary angiography at Imam Hossein Hospital, Tehran, between 2023 and 2024 were consecutively enrolled. Patients with hypertension, valvular heart disease, heart failure, or respiratory diseases were excluded. Cases (n = 45) had coronary artery disease (≥ 50% stenosis on angiography), while controls (n = 45) had no significant stenosis. Left atrial volume index (LAVI) was measured by echocardiography and classified as abnormal if ≥ 34 mL/m². All variables including LAVI were compared between two groups. Multivariate logistic regression was performed to investigate the role of variables in predicting CAD incidence in diabetic patients.
Results
A total of 90 patients with type 2 diabetes were included (45 with CAD and 45 without CAD); the mean age was 51.48±5.68 years, and 60% were male. Analyses revealed that LAVI values were significantly higher in patients with CAD compared to those without (P = 0.018), while there were no significant differences between two groups regarding gender, age, smoking, insulin dependence, diabetes duration, HbA1c, FBS, EF. also, no significant differences were observed in other echocardiographic measures including mild LVH, mild diastolic dysfunction, heart rate. Multivariate logistic regression identified LAVI as an independent predictor of CAD (OR = 1.24; 95% CI: 1.06–1.45), P = 0.006. ROC curve analysis showed that a LAVI cut-off of 28 mL/m² predicted CAD with 71% sensitivity and 51% specificity (P = 0.016).
Conclusion
LAVI could be a potentially useful, accessible and practical index for screening CAD in diabetic patients. It may be proposed as part of the workup for the diagnosis and management of CAD in type 2 diabetic patients.