Abstract Background Atrial fibrillation (AF) is among the most prevalent arrhythmias. Its onset after an acute coronary syndrome (ACS) is especially notable given the high coronary disease burden. Mineral metabolism, particularly fibroblast growth factor 23 (FGF23), has been linked to cardiovascular outcomes. This study examines whether FGF23, related markers and other variables can predict AF occurrence after an ACS, considering age differences. Methods Data were obtained from the BACS p = 0.026). Among patients > 65 years, a history of stroke was associated with a heightened risk (HR 2.75 1.03, 7.34; p = 0.044), while beta-blocker therapy appeared to be protective (HR 0.42 0.23, 0.78; p = 0.007). Previous AF consistently forecasted recurrence across both groups (HR 11.3 2.92, 43.6; p = 0.002 and HR 6.41 3.13, 13.1; p < 0.001, respectively). Conclusions FGF23 seems to be an independent and positive predictor of AF after an ACS in patients ≤ 65 years, whereas in older individuals, beta‐blocker therapy emerges as a potential protective measure. These insights may enhance current risk models with age-specific adjustments and encourage more tailored clinical strategies in post-ACS patients. Graphical Abstract
Larre-Guerra et al. (Mon,) studied this question.