The inflammatory prognostic index predicts new-onset atrial fibrillation in patients after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Abstract

Introduction&Objective: New-onset atrial fibrillation (NOAF) is an independent predictor of mortality and a strong indicator of poor prognosis following ST-segment elevation myocardial infarction (STEMI). The Inflammatory Prognostic Index (IPI) is clinically significant in predicting patient outcomes and serves as a novel inflammatory prognostic marker based on C-reactive protein (CRP), the neutrophil-to-lymphocyte ratio (NLR), and serum albumin levels. This study aimed to investigate the relationship between the IPI and NOAF in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI). Material&Methods: The population for this retrospective study consisted of 1,132 consecutive patients diagnosed with STEMI who underwent pPCI. Out of these, 946 patients were included in the study sample and were divided into two groups based on whether they developed NOAF or not. Results: The study’s primary outcome, that is, IPI was significantly higher in patients with NOAF than in those with No-AF (42.15 (17.6-81.7) vs. 12.77 (5.72-27.01), p<0.001) Univariate logistic regression analysis revealed significant correlations between NOAF; IPI, LVEF and age. Further analysis of these variables using the multivariate logistic regression analysis indicated that IPI (Odds Ratio [OR]: 2.026, 95% confidence interval [CI]: 1.081-3.799; p=0.028), LVEF and age were independent predictors for the development NOAF. IPI optimal cut-off value of >17.5 predicted NOAF with 76% sensitivity and 62.7% specificity (AUC: 0.740 [95% CI: 0.711–0.768, p<0.0001] (P<0.0001). Conclusion: This study finds that the IPI independently predicts NOAF in STEMI patients treated with pPCI.

Keywords

• Inflammatory prognostic index
• ST-segment elevation myocardial infarction
• Atrial fibrillation.

References

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