A systematic review and meta-analysis of 17 studies and 9,404 patients with coronary artery disease found that, in acute coronary syndrome, each 1% higher left atrial reservoir strain was associated with lower major adverse cardiovascular-event risk (pooled adjusted HR 0.94, 95% CI 0.92–0.95; I²=27%). This supports prognostic-marker potential but does not yet show added value over standard models or improved treatment outcomes.
Key findings
- Fifteen of 17 studies enrolled ACS populations and only two enrolled chronic or stable CAD. The primary ACS analysis used adjusted hazard ratios with low-to-moderate heterogeneity, and associations were consistent across imaging modality and assessment timing. Stable CAD could not be pooled separately.
Why this matters globally
LASr may add diastolic and atrial–ventricular information not captured by ejection fraction. Routine use requires standardised acquisition across vendors, reproducibility, thresholds, incremental discrimination and evidence that it changes useful decisions.
Thai researcher contribution
Suchanart Pantarote of Putthada Bangkhae Clinic, Bangkok contributed to data curation, formal analysis, investigation and manuscript review. Publisher verification also corrects an OpenAlex mis-link that had assigned PTT Public Company Limited.
Limitations to consider
Most source studies were observational, with variable MACE definitions, measurement methods and adjustment. A per-1% estimate assumes linearity and supplies no shared threshold; stable-CAD evidence is sparse. Association does not prove that LASr-guided care reduces events.