Predictive value of platelet-to-albumin ratio combined with the C 2 HEST score for New-Onset atrial fibrillation in elderly patients with acute ST-segment elevation myocardial infarction.

Background: New-onset atrial fibrillation (NOAF) is a common adverse outcome in acute ST-segment elevation myocardial infarction (STEMI) patients following percutaneous coronary intervention (PCI) and is associated with a worse prognosis. The platelet-to-albumin ratio (PAR) has been utilized to predict the severity and prognosis of cardiovascular diseases. This study aims to investigate the predictive value of PAR combined with the C ₂ HEST score for NOAF in the elderly population with STEMI undergoing PCI.
Methods: 445 elderly STEMI patients without a history of atrial fibrillation (AF) who underwent PCI were consecutively enrolled in this study. Multivariate logistic regression analysis was used to identify independent risk factors for NOAF after PCI.
Results: 50 patients (11.2%) developed NOAF after PCI. Multivariate logistic regression analysis revealed that heart rate (HR), systemic immune-inflammation index (SII), uric acid (UA), PAR, and C ₂ HEST score were independent risk factors for NOAF. The area under the curve (AUC) of the combined PAR and C ₂ HEST score was 0.839, and Delong's test indicated that the combined model had superior predictive value compared to individual markers (AUC of PAR: 0.738; AUC of C ₂ HEST score: 0.752) (P < 0.05). The addition of PAR and C ₂ HEST score to this model (HR, SII, and UA) significantly improved the reclassification and discrimination ability (IDI 0.175; NRI 0.734, both P < 0.001). During regular follow-up, the incidence of MACE was higher in the NOAF group compared to the non-NOAF group.
Conclusion: The combination of PAR and the C ₂ HEST score has a high predictive value for NOAF in elderly STEMI patients following PCI.
(© 2024. The Author(s).)