Risk factors of new-onset atrial fibrillation in patients with acute myocardial infarction

CHEN Ying; XIA Jing-gang

doi:10.3969/j.issn.1672-5301.2025.05.012

Abstract：Objective To explore the risk factors associated with newly diagnosed atrial fibrillation(NOAF)in patients with acute myocardial infarction(AMI).Methods A total of 628 patients with AMI who were admitted to Xuanwu Hospital of Capital Medical University from January 2021 to December 2021 were included.NOAF was defined as atrial fibrillation detected by electrocardiogram at admission or during hospitalization.The demographic,clinical,laboratory,echocardiography and coronary angiography data were collected.The independent risk factors of NOAF in AMI patients were determined by multivariate logistic regression analysis.Results Among the 628 AMI patients,48 had NOAF,with an incidence rate of 7.6％.There were no significant differences in white blood cell count,platelet count,triglycerides,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,uric acid,hemoglobin A1c,lesion number,infarction site,hypertension,diabetes and old infarction between the NOAF and non-NOAF groups(P＞0.05).The percentage of woman was higher in the NOAF group and subjects in this group were significantly elder than those in the non-NOAF groups(P＜0.01).The C-reactive protein(CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP),serum creatinine peak value(Scr)and troponin Ⅰ peak value(TnⅠ)were significantly higher in the NOAF group than in the non-NOAF group(P＜0.05).Killip grade in the NOAF group was worse than that in the non-NOAF group(P＜0.01).Body weight in the NOAF group was lower than that in the non-NOAF group(P＜0.05);hemoglobin and estimated glomerular filtration rate(eGFR)in the NOAF group were lower than those in the non-NOAF group(P＜0.01).The hospital stay in the NOAF group was significantly longer than that in the non-NOAF group[(12.46±8.05)days vs.(8.66±4.53)days,P＜0.01],and the in-hospital mortality(10.4％ vs.1.4％,P＜0.01)was higher than that in the non-NOAF group.Logistic multivariate regression analysis showed that age(OR=1.052,95％CI 1.005-1.102,P=0.031),CRP(OR=1.026,95％CI 1.007-1.046,P=0.007),NT-pro-BNP(OR=1.796,95％CI 1.473-2.191,P＜0.01)and left atrial diameter(OR=1.087,95％CI 1.029-1.148,P=0.003)were the independent predictors of NOAF after AMI.Conclusion Advanced age,increased CRP,NT-proBNP levels and enlarged left atrium indicate an increased risk of NOAF in patients with AMI.