Uric Acid-to-HDL Cholesterol Ratio as an Independent Predictor of In-Hospital New-Onset Atrial Fibrillation in...

Area of Science:

• Cardiology
• Biomarker Research
• Clinical Prediction Models

Background:

• Non-ST-elevation myocardial infarction (NSTEMI) is a critical cardiovascular condition.
• New-onset atrial fibrillation (NOAF) is a common complication during NSTEMI hospitalization.
• Identifying predictive biomarkers for NOAF in NSTEMI patients is crucial for risk stratification.

Purpose of the Study:

• To investigate the association between the uric acid-to-high-density lipoprotein cholesterol ratio (UAHDLr) and the risk of in-hospital new-onset atrial fibrillation (NOAF).
• To evaluate UAHDLr as a potential predictive biomarker for NOAF in patients with non-ST-elevation myocardial infarction (NSTEMI).

Main Methods:

• Retrospective cohort study of NSTEMI patients without prior atrial fibrillation.
• Log2-transformation of UAHDLr to assess the effect of doubling.
• Feature selection using LASSO regression and Cox proportional hazards models with sequential adjustments.
• Restricted cubic spline analysis for nonlinear associations and time-dependent ROC analysis for discrimination.

Main Results:

• UAHDLr was independently associated with in-hospital NOAF across all adjusted models.
• A 1-unit increase in log2-transformed UAHDLr significantly elevated NOAF risk (fully adjusted HR: 13.40).
• Restricted cubic spline analysis revealed a progressive increase in NOAF risk with higher UAHDLr values, with stable discrimination (AUC ~0.76).

Conclusions:

• UAHDLr is a potent and accessible biomarker for predicting in-hospital NOAF in NSTEMI patients.
• UAHDLr can aid in the early risk stratification of NSTEMI patients susceptible to developing atrial fibrillation.
• This finding supports the clinical utility of UAHDLr in cardiovascular risk assessment.