ArticleJournal of the American Heart Association2026
Sex-Specific Prognostic Value of Left Atrioventricular Coupling Index in Acute Coronary Syndrome: Insights From Artificial Intelligence-Enhanced 3-Dimensional Echocardiography.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLeft atrioventricular coupling index (LACI) has emerged as a prognostic biomarker, but its sex-specific relevance in acute coronary syndrome remains unclear.
methodsThis retrospective cohort included 880 patients with acute coronary syndrome (625 men; 255 women) undergoing percutaneous coronary intervention between February 2022 and June 2023. LACI was automatically quantified from 3-dimensional echocardiography using an artificial intellgience-based dynamic heart model. Patients were stratified by sex-specific median LACI values and followed for major adverse cardiovascular events. Cox proportional hazards and Fine-Gray competing risk models evaluated associations between LACI and outcomes. A sensitivity analysis was performed in 3 ways: (1) using propensity score matching, (2) excluding patients with atrial fibrillation, and (3) repeating propensity score matching in the cohort after excluding patients with atrial fibrillation. Results were verified in 3 independent cohorts: 285 internal validation, 124 coronary computed tomography angiography, and 128 external 3-dimensional echocardiography cohorts.
resultsOver a median 18-month follow-up, 219 major adverse cardiovascular events occurred. Women had significantly higher median LACI values than men. LACI was significantly associated with increased major adverse cardiovascular event risk in men (hazard ratio [HR], 1.23 [95% CI, 1.03-1.46];
conclusionsArtificial intelligence-derived LACI from 3-dimensional echocardiography demonstrates clear sex-specific prognostic value in acute coronary syndrome, and is significantly associated with adverse cardiovascular outcomes in men but not in women. These results support sex-specific risk stratification and highlight the clinical relevance of atrioventricular coupling assessment. REGISTRATION: URL: https://www.chictr.org.cn/. Unique identifier: ChiCTR2500099592.
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