Analysis Of Risk Factors And Prognosis Of New-onset Atrial Fibrillation In Patients After Emergency Percutaneous Coronary Intervention

Background and purpose:Acute myocardial infarction(AMI)is an acute and of coronary heart disease and is the main cause of death and disability in cardiovascular disease throughout the world.The incidence of AMI is increasing,and the overall mortality rate is on the rise.Atrial fibrillation(AF)is a common arrhythmia with a variety of causes,and its incidence increases with age.In the general population,the incidence of AF is also increasing year by year.AF is a common complication of AMI.AF and AMI have common risk factors,and AMI with new-onset atrial fibrillation(NOAF)may be associated with a worse prognosis.The purpose of this study was to investigate the risk factors for NOAF in patients undergoing emergency PCI and to evaluate the prognostic impact of NOAF in such patients.Methods: 379 AMI patients who attended the Department of Cardiology for emergency PCI from January 2019 to December 2021 were included.According to whether NOAF occurred,it was classified into NOAF group(n=47)and non-NOAF group(n=332).General clinical data and biochemical test indicators,coronary angiography data,cardiac color ultrasound and electrocardiogram were collected,and the above statistically significant factors were taken as independent variables,and independent multivariable logistics regression was used to analyze the independent risk factors of NOAF.In addition,patients were followed up for 1 year.Main information was collected including cardiovascular death,heart failure rehospitalization,ischemic stroke,and cardiovascular hemorrhage and coronary revascularization of all patients after discharge.Results:The incidence of NOAF in patients after emergency PCI was 12.4%(47 /379).There were no significant differences in Body mass index(BMI),history of hypertension,triglycerides(TG),total cholesterol(TC),troponin I(c Tn I),Creatine kinase MB isoenzyme(CK-MB),low density lipoprotein(LDL),D-dimer,international standard ratio(INR)in both groups,serum potassium(K),serum sodium(Na),serum chloride(Cl),alanine aminotransferase(ALT),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESd),and stent history(P> 0.05).Differences in age,sex,smoking,admission random blood glucose,plasma N-terminal B-type natriuretic peptide(NT-pro BNP),high density lipoprotein(HDL),blood creatinine(Cr),aspartate aminotransferase(AST),free thyroid hormone(FT4),Syntax score,left atrial diameter(LAD),left ventricular ejection fraction(LVEF),stent number 2,and diseased vessel branch number 2 in both groups(P <0.05).Introduction of the above independent variables into the logistic regression analysis revealed that,Age(OR = 1.054,95%CI of1.010–1.101,P=0.016),Syntax score(OR = 1.066,95%CI of 1.006–1.130,P=0.031),left atrial internal diameter(OR = 1.091,95%CI of 1.010–1.178,P=0.027),the left ventricular ejection fraction(OR = 0.956,95%CI of 0.918 – 0.994,P=0.024),NTpro BNP(OR=1.000,95%CI of 1.000–1.001,P=0.023)was a risk factor for NOAF in patients after emergency PCI.Significant differences in hospital stay,cardiovascular death,heart failure rehospitalization,ischemic stroke and hemorrhage rates between the two groups(P <0.05).Conclusions:Age,Syntax score,NTpro BNP,left atrial diameter and left ventricular ejection fraction are independent risk factors for NOAF in patients after emergency PCI,which may have certain reference value for predicting the occurrence and development of NOAF clinically.Patients with the NOAF had a higher incidence of cardiovascular death,heart failure rehospitalization,ischemic stroke and hemorrhage within 1 year than those in the non-NOAF,suggesting a poor prognosis in patients with NOAF.