Related Experiment Video
Updated: Apr 22, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Predicting atrial fibrillation after an acute coronary syndrome: insights from the BACS & BAMI study
Jaime Francisco Larre-Guerra1, Álvaro Castrillo-Capilla1, Macarena Garbayo-Bugeda1
1Department of Cardiology, IIS-Fundación Jiménez Díaz, 28040, Madrid, Spain.
Insights
Fibroblast growth factor 23 (FGF23) predicts atrial fibrillation (AF) after acute coronary syndrome (ACS) in younger patients. In older patients, beta-blocker therapy may prevent AF, suggesting age-specific risk stratification.
Area of Science:
- Cardiology
- Endocrinology
- Clinical Research
Background:
- Atrial fibrillation (AF) is a common arrhythmia, particularly following acute coronary syndrome (ACS).
- Mineral metabolism, including fibroblast growth factor 23 (FGF23), is implicated in cardiovascular health.
- Understanding predictors of AF post-ACS is crucial for patient management.
Purpose of the Study:
- To investigate the predictive value of FGF23 and other factors for AF development after ACS.
- To analyze age-specific differences in AF prediction in post-ACS patients.
Main Methods:
- The study included 1189 patients from the BACS & BAMI study.
- Baseline data and annual monitoring were utilized.
- Univariate and multivariate Cox analyses were performed, stratified by age (≤65 and >65 years).
Main Results:
- AF developed in 5.5% of patients over a median follow-up of 5.44 years.
- In patients ≤65 years, FGF23 was an independent predictor of AF (HR 1.37).
- In patients >65 years, prior stroke increased risk (HR 2.75), and beta-blockers showed a protective effect (HR 0.42). Previous AF predicted recurrence in both age groups.
Conclusions:
- FGF23 may predict AF post-ACS in younger patients (≤65 years).
- Beta-blocker therapy appears protective against AF in older patients (>65 years) post-ACS.
- Age-specific adjustments to risk models and tailored clinical strategies are warranted for post-ACS patients.
Background:
Atrial fibrillation (AF) is among the most prevalent arrhythmias. Its onset after an acute coronary syndrome (ACS) is especially notable given the high coronary disease burden. Mineral metabolism, particularly fibroblast growth factor 23 (FGF23), has been linked to cardiovascular outcomes. This study examines whether FGF23, related markers and other variables can predict AF occurrence after an ACS, considering age differences.
Methods:
Data were obtained from the BACS & BAMI study, including 1189 patients from five Madrid hospitals. Baseline clinical characteristics and laboratory results were recorded. Patients were monitored annually through clinical appointments. Univariate and multivariate Cox analyses were conducted separately for patients aged ≤ 65 and > 65 years, based on CHA2DS2-VA thromboembolic score.
Results:
Over a follow-up of 5.44 (3.03-7.46) years, 5.5% of patients developed AF. In those ≤ 65 years, FGF23 was an independent predictor of the development of AF (HR 1.37 [1.04, 1.79] per 100-unit rise; p = 0.026). Among patients > 65 years, a history of stroke was associated with a heightened risk (HR 2.75 [1.03, 7.34]; p = 0.044), while beta-blocker therapy appeared to be protective (HR 0.42 [0.23, 0.78]; p = 0.007). Previous AF consistently forecasted recurrence across both groups (HR 11.3 [2.92, 43.6]; p = 0.002 and HR 6.41 [3.13, 13.1]; p < 0.001, respectively).
Conclusions:
FGF23 seems to be an independent and positive predictor of AF after an ACS in patients ≤ 65 years, whereas in older individuals, beta-blocker therapy emerges as a potential protective measure. These insights may enhance current risk models with age-specific adjustments and encourage more tailored clinical strategies in post-ACS patients.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Dysrhythmias V: Evaluating Dysrhythmias