Accuracy of C2HEST and HARSM2-AF Scores in Predicting Atrial Fibrillation After Acute Coronary Syndrome Treated with Percutaneous Coronary Intervention

Introduction The new onset atrial fibrillation (NOAF) is a complication that should not be dismissed after an acute coronary syndrome since this association is characterized by a high ischemic risk. Methods We investigated the performance of C2HEST and the HARMS2-AF scores for predicting NOAF during hospitalization in patients admitted with ACS treated with percutaneous coronary intervention (PCI). Results Among the 763 patients eligible for the inclusion criteria, 64 patients developed NOAF during the index hospitalization, with an incidence of 8.38%. For the C2HEST score, the mean score in the NOAF group was higher than in the other group [NOAF versus No NOAF: 2.45 (± 1.79) versus 1.27 (± 1.43), p < 0.001], and ROC analysis showed good accuracy of C2HEST score in predicting NOAF with cut-off ≥3 [AUC = 0.699; 95%CI [0.665; 0.731], p < 0.001]. For the HARMS2-AF score, the mean score in the NOAF group was higher than in the other group [NOAF versus No NOAF: 9.22 (± 3.5) versus 6.72 (± 2.94), p < 0.001] and ROC analysis showed good accuracy of C2HEST score in predicting NOAF with cut-off≥7 [AUC = 0.722; 95%CI [0.689; 0.754], p < 0.001], and the comparison of the two scores found no significant difference with de long test p value at 0.326. A multivariate logistic regression analysis showed that C2HEST score >3 (OR = 1.86, p = 0.043) and HARMS2-AF >7 (OR = 3.91, p < 0.001) were independently associated with NOAF. Conclusion The C2HEST and HARMS2-AF are simple scores that can predict NOAF in patients with ACS treated with PCI with good accuracy.