Relationship between HAVOC score and new-onset atrial fibrillation in patients with ST elevation myocardial infarction

Background Atrial fibrillation (AF) is a common electrical complication in patients with acute myocardial infarction. The HAVOC score was originally proposed as a clinical tool for predicting AF in patients with cryptogenic stroke or transient ischemic attack. This study evaluated the predictive value of the HAVOC score for new-onset AF (NOAF) in patients with ST-segment elevation myocardial infarction (STEMI). Method Between August 2019 and December 2024, the data of 1640 patients (mean age: 56.3 ± 11.2 years, male: 1134, 69.1%) with STEMI were retrospectively analyzed. Patients were divided into two groups: those with and those without NOAF. All patients underwent electrocardiographic monitoring and echocardiographic evaluation following primary percutaneous coronary intervention. Results Overall, NOAF was observed in 115 patients. A comparison of the clinical and demographic characteristics between the groups showed that age, hypertension frequency, chronic obstructive pulmonary disease, and history of stroke were higher in the NOAF group. Left ventricular ejection fraction was significantly lower (38.2 ± 10.8 vs. 47.9 ± 10.1%, p < 0.001) and left atrial diameter (42.2 ± 4.5 vs. 37.5 ± 4.1 mm, p = 0.001) was significantly higher in these patients. Furthermore, the incidence of unsuccessful intervention, contrast-induced nephropathy, and in-hospital mortality as well as the HAVOC score were significantly higher in patients with NOAF. A high HAVOC score (odds ratio [OR] = 1.078; 95% confidence interval [CI]: 1.022–1.258; p = 0.001) was identified as an independent predictor of NOAF in patients with STEMI. Conclusion The HAVOC score appears to be a useful tool for predicting NOAF in patients with STEMI. Identifying individuals with high HAVOC scores may enable early recognition and prevention of AF-related complications.