• Zhitong Li, Quanbo Liu, Fei Liu, Tesfaldet H Hidru, Yiheng Yang, Shihao Wang, Lan Bai, Jing Chen, Xiaolei Yang, and Yunlong Xia.
• Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, No.193, Lianhe Road, Dalian, Liaoning 116000, China.
• Eur. J. Intern. Med. 2022 Aug 1; 102: 727972-79.

BackgroundNew-onset atrial fibrillation (NOAF) after acute myocardial infarction (AMI) is common and independently correlated with poor prognosis. The purpose of this study is to explore whether atrial cardiomyopathy (ACM) markers improve NOAF risk assessment and contribute to therapy decision-making to improve prognosis.MethodsWe retrospectively analyzed 4713 patients with AMI without a documented history of atrial fibrillation (AF). We measured markers of ACM including P-wave terminal force in ECG lead V1 (PTFV1), Left atrial dimension (LAD), and B-type natriuretic peptide (BNP). Patients were stratified into tertiles of PTFV1, LAD, and BNP levels. Associations between markers and NOAF were evaluated using logistic regression analysis.ResultsOverall, 222 (4.71%) patients had NOAF out of 4713 patients. The prevalence of NOAF increased gradually with PTFV1, LAD, and BNP tertiles. On multivariable regression analysis with potential confounders, elevated PTFV1, LAD, and BNP markers were significantly associated with an increased risk of NOAF. The addition of PTFV1, LAD, and BNP to the AF risk factors recommended by the 2020 ESC Guidelines significantly improved risk discrimination for NOAF.ConclusionAtrial cardiomyopathy markers including PTFV1, LAD, and BNP were strongly associated with NOAF after AMI. The prediction performance of the clinical model for NOAF was increased by the addition of these markers.Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.

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