Objective: To investigate the connection between Naples prognostic score (NPS) and new-onset atrial fibrillation (NOAF) in ST- segment elevation myocardial infarction (STEMI) cases following revascularisation.
Study design: An observational study. Place and Duration of the Study: Department of Cardiology, Yijishan Hospital, Affiliated to Wannan Medical College, Wuhu, China, from December 2016 to February 2023.
Methodology: The investigation recruited 683 consecutive STEMI patients after percutaneous coronary intervention (PCI), categorising them into two groups: NOAF group and sinus rhythm (SR) group. Analyses involving both multivariate logistic regression and receiver operating characteristic (ROC) curves were performed to evaluate the predictive capability of NPS for NOAF development. Additionally, the Kaplan-Meier method was employed to assess the differences in all-cause mortality between the two groups.
Results: Fifty-one (7.5%) patients of the present study developed NOAF during hospitalisation. NPS was found to be independently predictive of NOAF (NPS as continuous variable, odds ratio [OR], 2.207; 95% confidence interval [CI], 1.305-3.732; p <0.05; NPS as categorical variable, OR, 5.616; 95% CI, 1.252-25.198; p <0.05). The optimal NPS threshold for predicting NOAF development in STEMI patients post-PCI was greater than 2 (p <0.001). Furthermore, the all-cause mortality rate among individuals complicated with NOAF is significantly elevated in comparison to that of the SR group over a median follow-up duration of 44 months (Log-rank p <0.001).
Conclusion: NPS is independently predictive of NOAF among STEMI individuals who underwent PCI. Furthermore, NOAF is strongly linked to a poor prognosis after discharge.
Key words: Naples prognostic score, New-onset atrial fibrillation, ST-segment elevation myocardial infarction, Prognosis.