Predictive factors for new-onset atrial fibrillation in acute coronary syndrome patients undergoing percutaneous
Zhiyuan Zhang1, Chunfang Hu2, Ruzhu Wang3
1Department of Cardiovascular Medicine, Taizhou People's Hospital, Taizhou, China - zzy3374@163.com.
Insights
New-onset atrial fibrillation (AF) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) is predicted by cardiogenic shock, left atrial volume index (LAVI), and age. Higher LAVI correlates with increased AF incidence.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) are at risk for new-onset atrial fibrillation (AF).
- Identifying predictive factors for AF in this population is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the independent predictive factors for new-onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
Main Methods:
- A cohort of 934 ACS patients treated with PCI were followed for 1 year.
- Clinical, angiographic, and echocardiographic data were collected and analyzed.
- Multivariate Logistic regression identified independent risk factors for new-onset AF.
Main Results:
- Patients who developed new-onset AF were older and had higher rates of cardiogenic shock and heart failure.
- Elevated left atrial volume index (LAVI) and decreased left ventricular ejection fraction (LVEF) were observed in the AF group.
- Cardiogenic shock, LAVI, and age were identified as independent predictors of new-onset AF.
Conclusions:
- Cardiogenic shock, elevated LAVI, and advanced age are significant independent predictors of new-onset AF in ACS patients post-PCI.
- Increasing LAVI is associated with a progressively higher incidence of AF.
Background:
The aim of this study is to investigate the predictive factors for new-onset atrial fibrillation (AF) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).
Methods:
A total of 934 ACS patients admitted into the Department of Cardiology from February 2015 to February 2017 were collected. All patients were treated with PCI after admission and followed up for 1 year. Data of patients, such as age, gender, past medical history, dyslipidemia, cardiogenic shock, heart failure, medication, culprit vessel, echocardiographic characteristics and types of ACS were collected. Patients enrolled were divided into AF group and non-AF group according to whether there was new-onset AF or not. The clinical baseline data, coronary angiographic results and echocardiographic characteristics were compared between the two groups. The left atrial volume index (LAVI) and incidence rate of AF were compared using the histogram, and multivariate Logistic regression analyses were conducted for independent risk factors for new-onset AF in ACS patients undergoing PCI.
Results:
In terms of clinical baseline data and coronary angiographic results, the average age and proportions of female, hypertension, heart failure, cardiogenic shock and application of β-receptor blockers and antiarrhythmic drugs in AF group were significantly increased compared with those in non-AF group (P<0.05). In terms of echocardiographic characteristics, the mitral E peak, LAVI, and proportions of E/Em>15 and proportions of left ventricular ejection fraction (LVEF) <40% were significantly increased (P<0.05), but LVEF was obviously decreased (P<0.05) in AF group compared with those in non-AF group. According to multivariate Logistic regression analyses, cardiogenic shock, LAVI and age were independent risk factors for new-onset AF in ACS patients undergoing PCI. The comparison among patients with different LAVI showed that with the increase of LAVI, the incidence rate of AF was gradually increased.
Conclusions:
Cardiogenic shock, LAVI and advanced age are independent predictive factors for new-onset AF in ACS patients undergoing PCI. The incidence rate of AF was gradually increased with the increase of LAVI.
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