Analysis of risk factors and construction of a nomogram model for atrial fibrillation in young patients

CHEN Jia-ying; CHEN Shu-fang; WU Jin-tao; ZHANG Lei-ming; SHI Hui-ting; LI Xue-jie; HUANG Li-li; HU Guang-ling

doi:10.3969/j.issn.1672-5301.2025.11.002

Abstract：Objective To investigate the risk factors associated with atrial fibrillation(AF)in the young patients to establish a corresponding nomogram model and evaluate its validity.Methods The data of 959 consecutive patients aged≤35 years who were hospitalized in Fuwai Central China Cardiovascular Hospital for diagnosis and treatment from January to June 2023 were retrospectively analyzed,including 85(8.9%)with AF(the AF group)and 874(91.1%)without AF(the non-AF group).Univariate and multivariate Logistic regression analyses were used to identify the risk factors for AF and established a nomogram model.The discriminative ability and calibration of the model were assessed using the receiver operating characteristic(ROC)curve and calibration curve,respectively.The decision curve analysis was employed to evaluate the net benefit of the model.Results Univariate Logistic regression analyses showed that the age,male,history of smoking,history of alcohol consumption,valvular heart disease,dilated cardiomyopathy,heart failure,renal insufficiency,obstructive sleep apnea(OSA),family history of AF,non-alcoholic fatty liver disease(NAFLD),left atrial diameter(LAD),left ventricular ejection fraction,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,right atrium medial-lateral dimension,right atrial superior-inferior dimension,serum albumin,uric acid,serum creatinine and glomerular filtration rate were associated with AF in the young patients.Multivariate Logistic regression analysis revealed that the history of alcohol consumption,dilated cardiomyopathy,OSA,family history of AF,NAFLD,LAD and serum albumin were the independent risk factors for AF in these patients(P<0.05).A nomogram model incorporating these factors was developed to predict the occurrence of AF in the young patients.The area under the ROC curve(AUC)was 0.830(95%CI 0.779-0.882).The Hosmer-Lemeshow test showed χ2=11.201,P=0.191(P>0.05).Internal validation using Bootstrap method with 1,000 resamples demonstrated high quality of the calibration curve.Decision curve analysis indicated a satisfactory net benefit range.Conclusion The history of alcohol consumption,dilated cardiomyopathy,OSA,family history of AF,NAFLD,LAD and serum albumin were the independent risk factors for AF in the young patients.The nomogram model established in this study has good predictive efficacy and discriminative ability.