Prognostic indicators of new onset atrial fibrillation in patients with acute coronary syndrome.

Abstract

BackgroundThis study aims to estimate prognostic indicators of new onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) through 3 to 5 years of follow‐up.HypothesisFor patients with ACS, some prognostic indicators can be used to predict new onset AF.MethodsThe Improving Care for Cardiovascular Disease in China‐ACS (CCC‐ACS) program was launched in 2014 by a collaborative initiative of the American Heart Association and Chinese Society of Cardiology. We enrolled 866 patients with ACS in a telephone follow‐up program. We inquired about each patient's general health and invited each patient to our hospital for further consultation. We also performed ambulatory electrocardiography and other relevant examinations.ResultsA total of 743 ACS patients were included in the study. After 3 to 5 years, 50 (0.67%) patients developed AF. In multivariable Cox models adjusting for AF risk factors in ACS patients, we found that NT‐proBNP [hazard ratio (HR) 2.625, 1.654‐4.166, P < .05], creatine kinase‐MB (CK‐MB) (HR 4.279, 1.887‐9.703, P < .05), and left ventricular ejection fraction (LVEF) (HR 0.01, 0.001‐0.352, P < .05) were significantly associated with AF receiver operating characteristic (ROC) curves were used to determine a cutoff level for AF screening. NT‐proBNP using a cutoff of 1705 ng/L resulted in a sensitivity of 58% and a specificity of 89.8%. CK‐MB using a cutoff of 142.5 ng/L resulted in a sensitivity of 73.3% and a specificity of 58.3%.ConclusionFor patients with ACS, NT‐proBNP, CK‐MB, and LVEF have a considerable prognostic value for predicting whether AF would be detected during follow‐up.