Correlation Between P-Wave Index and New-Onset Atrial Fibrillation After PCI in STEMI Patients

Zhou Dan; He Ya; Yang Kang; Li Shenglan

doi:10.3969/j.issn.1674-4055.2025.09.11

Abstract：Objective To investigate the correlation between the P-wave index and new-onset atrial fibrillation(NOAF)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 120 STEMI patients who developed NOAF after PCI between January 2019 and May 2024 in 3201 Hospital were included(NOAF group).Another 120 STEMI patients who underwent PCI during the same period without NOAF were selected in a 1:1 ratio(non-NOAF group).A 12-lead electrocardiogram(ECG)was used to record the P-wave index,including P-wave duration,P-wave dispersion,PR interval,advanced interatrial block,abnormal P-wave axis,and peak P-wave terminal force in lead V1(PWPTV1).Multivariate conditional logistic regression was performed to determine the relationship between the P-wave index and NOAF after PCI in STEMI patients.The predictive efficacy of the P-wave index was assessed using the receiver operating characteristic(ROC)curve.Results The NOAF group had significantly longer P-wave duration,PR interval,and greater PWPTV1 compared to the non-NOAF group(P＜0.05).After adjusting for confounding factors,a prolonged P-wave duration,a prolonged PR interval,and an increased PWPTV1 were identified as independent risk factors for NOAF after PCI in STEMI patients(P＜0.05).The combined prediction model of P-wave duration,PR interval,and PWPTV1 yielded an area under the curve(AUC)of 0.845(95%CI:0.793～0.888),which was superior to the AUC of individual predictors:P-wave duration(0.655,95%CI:0.591～0.715),PR interval(0.658,95%CI:0.594～0.718),and PWPTV1(0.791,95%CI:0.734～0.840),(P＜0.05).Conclusion P-wave duration,PR interval,and PWPTV1 in the P-wave index are significantly associated with NOAF after PCI in STEMI patients.Their combined use provides a high predictive efficiency for NOAF occurrence.