After acute myocardial infarction (AMI), diastolic function assessed by Doppler echocardiography provides important prognostic information that is incremental to systolic function. However, these variables reflect the beat–to–beat interaction of LV filling pressures and ventricular compliance, making them sensitive to rapid alternations in ventricular preload and afterload. However, in contrast to other Doppler variables of LV diastolic function, which are affected by acute hemodynamic changes, LA volume is a more stable parameter, integrating the effects of elevated LV filling pressures from preexisting cardiovascular conditions as well as acute disease. This study was carried out in the period of January 2018 to June 2019 in the Department of cardiology, SCB Medical College & Hospital, Cuttack. 200 consecutive patients presenting to ICCU with first episode of acute ST elevation myocardial infarction (STEMI) were enrolled in this study. The LA volume was corrected for body surface area, and the population was divided according to LA volume index of 32 mL/m2 (2 SDs above normal). LA volume index was >32 mL/m2 in 70 (35%) patients. The primary study end point was all–cause mortality. During follow–up of 12 months, 31 patients (15.5%) died. LA volume index was a powerful predictor of mortality and remained an independent predictor of major adverse cardiovascular events even after adjustment for clinical factors, LV systolic function, and Doppler–derived parameters of diastolic function.