The MVP ECG risk score predicted new-onset atrial fibrillation with an AUC of 0.908, outperforming CHA2DS2-VASc (AUC 0.643) and C2HEST (AUC 0.715) scores in patients with acute myocardial infarction.
Observational (n=334)
No
Does the MVP ECG risk score predict new-onset atrial fibrillation better than traditional clinical risk scores in patients with acute myocardial infarction?
The MVP ECG risk score provides superior prediction of new-onset atrial fibrillation in patients with acute myocardial infarction compared to traditional clinical risk scores like CHA₂DS₂-VASc and C2HEST.
Estimación del efecto: AUC 0.908 for MVP score predicting total NOAF (95% CI 0.86-0.94)
valor p: p=<0.001
Background The prevalence of atrial fibrillation (AF) is approximately 1.5%–2% of the general population. The Morphology-Voltage-P Wave Duration (MVP) score, a novel electrocardiographic tool based on P -wave characteristics, has shown promise in predicting AF risk. New-onset atrial fibrillation (NOAF) following acute myocardial infarction (AMI) is associated with poor clinical outcomes. Methods This retrospective study included 334 patients treated for AMI from January 2018 to April 2021. Patients were categorized into low-risk (202 cases), medium-risk (98 cases), and high-risk (34 cases) groups based on MVP ECG scores. NOAF incidence, stratified as early-onset (≤48 h) and late-onset (48 h), was tracked over a 12-month follow-up period. Statistical analyses included group comparisons, Cox regression for multivariate adjustment, ROC analysis to evaluate and compare the predictive performance of the MVP score against both the CHA₂DS₂-VASc and the AF-specific C2HEST scores, and decision curve analysis (DCA) to assess clinical utility. Results The MVP ECG risk score effectively predicted long-term AF incidence, showing a graded increase in risk across categories: 11.9% in low-risk, 28.6% in medium-risk, and 76.5% in high-risk patients. Incidence increased for both early-onset (4.0%, 10.2%, 29.4%) and late-onset NOAF (7.9%, 18.4%, 47.1%). The MVP score demonstrated superior discriminative ability for total NOAF (AUC = 0.908) compared to the CHA₂DS₂-VASc score (AUC = 0.643) and the C2HEST score (AUC = 0.715), with the highest performance observed for late-onset NOAF (AUC = 0.925). Addition of the MVP score to either clinical score significantly improved reclassification (NRI: 0.28–0.35, IDI: 0.07–0.08). DCA confirmed that using the MVP score provided a greater net clinical benefit than the comparator scores across realistic decision thresholds. Multivariate analysis confirmed the MVP score as an independent predictor of AF, with a stronger association for late-onset events. Conclusion The MVP ECG risk score is a simple, non-invasive tool that provides superior prediction of NOAF in AMI patients compared to traditional clinical risk scores, exhibiting particular strength in identifying patients at risk for late-onset AF. It effectively identifies high-risk patients who may benefit from close monitoring and proactive management strategies.
Li et al. (Wed,) conducted a observational in Patients with acute myocardial infarction (AMI) admitted with high-quality ECG and echocardiographic data; age >18 years; no prior atrial fibrillation (n=334). Morphology-Voltage-P wave duration (MVP) ECG risk score stratification vs. CHA2DS2-VASc score and C2HEST score risk assessments was evaluated on Incidence of new-onset atrial fibrillation (NOAF) during 12-month follow-up (AUC 0.908 for MVP score predicting total NOAF, 95% CI 0.86-0.94, p=<0.001). The MVP ECG risk score predicted new-onset atrial fibrillation with an AUC of 0.908, outperforming CHA2DS2-VASc (AUC 0.643) and C2HEST (AUC 0.715) scores in patients with acute myocardial infarction.