Predictors of New-Onset Atrial Fibrillation Following AMI

The development of new-onset atrial fibrillation (NOAF) after acute myocardial infarction (AMI) is associated with worse outcomes. Researchers evaluated whether the stress hyperglycemia ratio (SHR) and neutrophil to lymphocyte ratio (NLR) could predict NOAF following AMI. In their report in Frontiers in Cardiovascular Medicine, they suggested that SHR and NLR were both independently associated with NOAF in patients with AMI.

The study included 3194 patients with AMI without any record of atrial fibrillation. The subjects were stratified by SHR and NLR measures, as well as diabetes status. The study’s authors developed a predictive nomogram model based on risk factors for NOAF and validated the model’s performance.

SHR and NLR Measures Predict NOAF AFter AMI

Among the patients, 245 (7.67%) developed NOAF after AMI. Of note, these patients had higher values of SHR and NLR compared with patients who didn’t develop NOAF, regardless of diabetes status. In adjusted analyses, the researchers established that high NHR and SHR were associated with NOAF risk. According to the article, the nomogram model demonstrated “satisfactory” performance based on area under the receiver operating characteristic curve and decision curve assessments.

Authors noted that some patients were excluded from the final analyses due tom issing data, which could have introduced selection bias. In addition, the population of NOAF post-AMI patients was small, and the investigators acknowledged that patients with pre-existing asymptomatic atrial fibrillation could have been reported as NOAF cases. Finally, ECG data was only collected during hospitalization, so no analyses of post-discharge outcomes could be performed.

Though the predictive nomogram model still requires verification in the external validation queue, the authors ultimately concluded that SHR and NLR are associated with NOAF risk in patients who experience AMI and that their model could help risk classification and treatment individualization.

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