ORIGINAL ARTICLE   

Panminerva Medica 2020 March;62(1):1-6

DOI: 10.23736/S0031-0808.18.03556-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Predictive factors for new-onset atrial fibrillation in acute coronary syndrome patients undergoing percutaneous coronary intervention

Zhiyuan ZHANG ¹ ✉, Chunfang HU ², Ruzhu WANG ¹, Jie LIN ¹, Zhongbao RUAN ¹

¹ Department of Cardiovascular Medicine, Taizhou People’s Hospital, Taizhou, China; ² Department of Critical Care Medicine, Taizhou People’s Hospital, Taizhou, China

BACKGROUND: The aim of this study is to investigate the predictive factors for new-onset atrial fibrillation (AF) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).
METHODS: A total of 934 ACS patients admitted into the Department of Cardiology from February 2015 to February 2017 were collected. All patients were treated with PCI after admission and followed up for 1 year. Data of patients, such as age, gender, past medical history, dyslipidemia, cardiogenic shock, heart failure, medication, culprit vessel, echocardiographic characteristics and types of ACS were collected. Patients enrolled were divided into AF group and non-AF group according to whether there was new-onset AF or not. The clinical baseline data, coronary angiographic results and echocardiographic characteristics were compared between the two groups. The left atrial volume index (LAVI) and incidence rate of AF were compared using the histogram, and multivariate Logistic regression analyses were conducted for independent risk factors for new-onset AF in ACS patients undergoing PCI.
RESULTS: In terms of clinical baseline data and coronary angiographic results, the average age and proportions of female, hypertension, heart failure, cardiogenic shock and application of β-receptor blockers and antiarrhythmic drugs in AF group were significantly increased compared with those in non-AF group (P<0.05). In terms of echocardiographic characteristics, the mitral E peak, LAVI, and proportions of E/Em>15 and proportions of left ventricular ejection fraction (LVEF) <40% were significantly increased (P<0.05), but LVEF was obviously decreased (P<0.05) in AF group compared with those in non-AF group. According to multivariate Logistic regression analyses, cardiogenic shock, LAVI and age were independent risk factors for new-onset AF in ACS patients undergoing PCI. The comparison among patients with different LAVI showed that with the increase of LAVI, the incidence rate of AF was gradually increased.
CONCLUSIONS: Cardiogenic shock, LAVI and advanced age are independent predictive factors for new-onset AF in ACS patients undergoing PCI. The incidence rate of AF was gradually increased with the increase of LAVI.

KEY WORDS: Atrial fibrillation; Acute coronary syndrome; Percutaneous coronary intervention; Cardiogenic shock