Association between the Albumin-to-Globulin Ratio and Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy

Background: Atrial fibrillation (AF), which occurs four to six times more frequently in hypertrophic cardiomyopathy (HCM) patients than in the general population, is the most common persistent arrhythmia and has a substantial therapeutic consequence. In HCM patients, there are currently no discovered signs that could be utilized to identify AF. Methods: From 2018 to 2022, 493 individuals with a continuous diagnosis of HCM were examined at Beijing Anzhen Hospital. AF was proven using routine electrocardiography (ECG), 24-hour Holter ECGs, or bedside ECGs. Echocardiography and blood tests were performed for all patients. Analysis and comparison of the traits were performed in HCM patients with AF (n = 77) and without AF (n = 416). Results: Age (p <0.001), prevalence of ventricular tachycardia (VT, p < 0.001), prevalence of pulmonary artery hypertension (p = 0.027), and albumin-to-globulin ratio (AGR, p = 0.046) were all significantly higher in patients with AF, compared to patients without AF. In multivariate logistic analysis, age (odds ratio OR, 1.063; 95% confidence interval CI, 1.032–1.095; p < 0.001), history of VT (OR, 2.702; 95% CI, 1.007–7.255; p = 0.048), AGR (OR, 3.477; 95% CI, 1.417–8.536; p = 0.007), left atrial diameter (OR, 1.132; 95% CI, 1.073–1.194; p < 0.001), left ventricular end-diastolic diameter (OR, 0.861; 95% CI, 0.762–0.974; p = 0.017), left ventricular end-systolic diameter (OR, 1.239; 95% CI, 1.083–1.417; p = 0.002), and peak A wave velocity (OR, 0.983; 95% CI, 0.972–0.994; p = 0.002) were independently associated with AF in HCM patients. In the receiver operating characteristic curve analysis, the area under the curve for the established model was 0.819 (95% CI, 0.755–0.883, p = 0.033), with a sensitivity and specificity of 0.763 and 0.816, respectively, for AF occurrence in HCM patients. Conclusions: In individuals with HCM, a history of VT and a higher AGR are independently linked to AF. Further investigation is necessary to determine whether increased AGR represents a risk factor for embolic stroke or cardiovascular death.