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. 2024 Sep 27;24(1):521.
doi: 10.1186/s12872-024-04200-7.

Predictive value of platelet-to-albumin ratio combined with the C2HEST score for New-Onset atrial fibrillation in elderly patients with acute ST-segment elevation myocardial infarction

Fangyuan Wang  1 , Yudan Sun  1 , Yuan Lu  2 , Defeng Pan  2 , Ni An  1 , Rongrong Liu  1 , Shengli Li  3 , Tian Liu  1 , Rongli Yang  4
Affiliations

Predictive value of platelet-to-albumin ratio combined with the C2HEST score for New-Onset atrial fibrillation in elderly patients with acute ST-segment elevation myocardial infarction

Fangyuan Wang et al. BMC Cardiovasc Disord. .

Abstract

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 C2HEST 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 C2HEST score were independent risk factors for NOAF. The area under the curve (AUC) of the combined PAR and C2HEST 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 C2HEST score: 0.752) (P < 0.05). The addition of PAR and C2HEST 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 C2HEST score has a high predictive value for NOAF in elderly STEMI patients following PCI.

Keywords: Acute myocardial infarction; C2HEST score; Elderly; New-onset atrial fibrillation; Platelet to albumin ratio.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
RCS for the odds ratio of the risk of NOAF
Fig. 3
Fig. 3
ROC curve for the prediction of NOAF after STEMI
Fig. 4
Fig. 4
The Kaplan–Meier curves of long-term MACE between the NOAF and non-NOAF groups
See this image and copyright information in PMC

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