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

BACKGROUND: This 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. HYPOTHESIS: For patients with ACS, some prognostic indicators can be used to predict new onset AF. METHODS: The 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. RESULTS: A 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%. CONCLUSION: For patients with ACS, NT-proBNP, CK-MB, and LVEF have a considerable prognostic value for predicting whether AF would be detected during follow-up.