Tricuspid annular plane systolic excursion over systolic pulmonary artery pressure prognostic value for in-hospital adverse events in patients hospitalized for acute coronary syndrome
Authors' conclusion
A low RV-PA coupling defined as TAPSE/sPAP ratio <0.55 was independently associated with in-hospital MACEs and provided incremental prognostic value over traditional prognosticators in patients hospitalized for ACS.
Study context
- Population
- Patients hospitalized in ICCU for acute coronary syndrome (ACS) (ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI)) with TAPSE/sPAP available, France
- Participants
- 481 patients
- Exposure
- TAPSE/sPAP <0.55 vs ≥0.55 mm/mmHg
- Outcome
- In-hospital MACE:
- All-cause death
- Resuscitated cardiac arrest
- Cardiogenic shock
- Follow-up
- In-hospital
Methodological detailsmulticentre (39 centres), consecutive patients
- Multicentre (39 centres)
- Consecutive patients
Main finding
As reported in the abstract
In-hospital MACE
TAPSE/sPAP <0.55 vs TAPSE/sPAP ≥0.55Odds ratio (95% CI)P value
Adjusted for comorbidities
19.1(7.78–54.8)
P < 0.001Adjusted for clinical severity incl. LVEF
14.4(5.70–41.7)
P < 0.001Propensity-matched population
22.8(7.83–97.2)
P < 0.001- In-hospital MACE, overall
- 33 (7%)
- Best TAPSE/sPAP cut-off by ROC curve analysis
- 0.55 mm/mmHg
Observational data: associations, not effects.
Further findings
Incremental prognostic value over traditional prognosticators
- C-statistic improvement
- 0.16
- Global χ2 improvement
- 52.8
- Likelihood ratio test
- P < 0.001
- Similar results in STEMI and NSTEMI subgroups
Original publication
Tricuspid annular plane systolic excursion over systolic pulmonary artery pressure prognostic value for in-hospital adverse events in patients hospitalized for acute coronary syndrome. Eur Heart J Cardiovasc Imaging. Published 23 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it