Left atrial-ventricular coupling index associated with new-onset atrial fibrillation in ST-segment elevation myocardial infarction patients.

BACKGROUND

The management of new-onset atrial fibrillation (NOAF) in ST-segment elevation myocardial infarction (STEMI) patients remains a challenge in clinical. Left atrial-ventricular coupling index (LACI) is a novel cardiovascular risk marker. Currently, the relationship between LACI and NOAF in STEMI patients is unclear. This study aims to investigate the association between LACI measured by cardiac magnetic resonance (CMR) and NOAF after PCI in STEMI patients.

METHODS

This is a single-center, retrospective study. Patients who were admitted for STEMI from September 2018 and December 2024 were consecutively enrolled. All patients completed CMR during hospitalization. LACI was calculated as the ratio of the left atrial end-diastolic volume index to the left ventricular end-diastolic volume index.

RESULTS

A total of 553 patients were included, of whom 46 developed NOAF. Multivariable logistic regression analysis indicated that LACI (OR = 1.10, 95% CI: 1.07-1.14, p < 0.001), microvascular obstruction (OR = 1.16, 95% CI: 1.07-1.26, p < 0.001), and heart rate (OR = 1.03, 95% CI: 1.01-1.06, p = 0.024) were independent risk factors for NOAF. Receiver operating characteristic (ROC) curve analysis showed that the AUC for LACI was 0.733 (95% CI: 0.636-0.830, p < 0.001). Integrating LACI significantly improved the NOAF risk model (NRI = 0.803, 95% CI: 0.5149-1.0917, P < 0.001; IDI = 0.127, 95% CI: 0.0606-0.1930, P < 0.001).

CONCLUSION

LACI is independently associated with the occurrence of NOAF after PCI in patients with STEMI. Incorporating LACI into the analytical model improves its ability to identify patients with higher NOAF risk.