Work

Development and validation of a nomogram for predicting atrial fibrillation after percutaneous coronary intervention in patients with acute myocardial infarction

Year: 2026

Type: article

Abstract: Background Atrial fibrillation (AF) is a frequent complication in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), contributing to adverse outcomes. Early identification of individuals at high risk for post-PCI AF is crucial for tailored monitoring and intervention strategies. This study aimed to develop and validate a predictive nomogram for new-onset AF in AMI patients treated with PCI. Methods A retrospective observational cohort of 268 AMI patients undergoing PCI between January 2023 and December 2024 was analyzed. Patients were divided into AF ( n = 56) and non-AF ( n = 212) groups based on documented AF within 6 months post-PCI. Baseline clinical, echocardiographic, laboratory, and procedural variables were collected. Multivariate logistic regression was used to identify independent predictors of post-PCI AF. A nomogram was constructed based on the final model. Discriminatory performance was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was evaluated using the Hosmer–Lemeshow test and internal bootstrap validation. Results Six independent predictors were identified: Gensini score, left atrial diameter, serum creatinine (SCr), prognostic nutritional index (PNI), symptom onset-to-PCI time, and post-PCI thrombolysis in myocardial infarction (TIMI) flow grade. The resulting nomogram demonstrated excellent discrimination (AUC = 0.916) and strong calibration (Hosmer–Lemeshow χ 2 = 0.967, p = 0.551; optimism-corrected C-index = 0.909). The model showed good internal validity and potential clinical utility for early risk stratification. Conclusion This study identified Gensini score, left atrial diameter, SCr, PNI, onset-to-PCI time, and final TIMI flow grade as independent predictors of post-PCI AF, and developed a nomogram with excellent predictive accuracy requiring validation in larger multicenter cohorts.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1672411

Authors: Yi-Bo Li, Zhi-Qiang Liu, Xian-Wei Tian, Peng-Fei Lu, Li-Pei Zhao

Institution: Xinxiang Central Hospital

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801