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Predictors of new-onset atrial fibrillation in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention

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Abstract

Background

The development of atrial fibrillation (AF) during the course of acute coronary syndrome (ACS) is related to poor prognosis. Possible predictors of new-onset AF (NOAF) have not been adequately investigated in elderly patients with ACS undergoing percutaneous coronary intervention (PCI). We aimed to identify the factors associated with NOAF in such patients.

Methods

A total of 308 elderly patients with ACS undergoing PCI were enrolled in the study. Patients were divided into two groups: without NOAF [254 patients, 64.6% men, age: 73.5 (69.0–79.0) years] and with NOAF [54 patients, 70.4% men, age: 75.0 (68.7–81.2) years]. Clinical, angiographic, and laboratory features including neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-high-density lipoprotein ratio (MHR) were compared between the groups.

Results

The percentages of prior myocardial infarction (MI) (20.4 vs. 5.9%) and Killip III/ IV (24.1 vs. 7.1%), NLR [4.5 (2.6–7.2) vs. 3.2 (2.0–6.0)], and MHR [19.4 (15.7–26.5) vs. 12.9 (9.9–18.5)] were higher in patients with NOAF compared to the others (p = 0.020, < 0.001, 0.030, and < 0.001, respectively). In multivariate regression analysis, prior MI (OR 4.509, 95% CI 1.679–12.106, p = 0.003) and MHR (OR 1.102, 95% CI 1.054–1.152, p < 0.001) independently predicted NOAF. In addition, Killip III/IV was found to be an independent predictor of 6-month overall mortality (HR 2.949, 95% CI 1.218–7.136, p = 0.016).

Conclusions

Prior MI and MHR are independent predictors of NOAF in elderly patients with ACS undergoing PCI. Killip III/IV predicts 6-month overall mortality in such patients.

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Acknowledgements

We are grateful for the assistances from Mehmet Eren Altınbaş, Özlem Karabulut, Nurcan Göküz and Sinem Tekin.

Funding

No financial support from any organization was used in the preparation of this article.

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Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Meşelik Kampüsü, 26480, Odunpazarı, Eskisehir, Turkey

    Taner Ulus & Ahmet Serdar Yilmaz

  2. Department of Cardiology, Anadolu Hospital, Eskisehir, Turkey

    Kamal Isgandarov

  3. Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

    Ibrahim Vasi

  4. Department of Cardiology, Kent Hospital, Izmir, Turkey

    Sayyed Hamed Moghanchızadeh

  5. Department of Biostatistics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

    Fezan Mutlu

Authors
  1. Taner Ulus
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  2. Kamal Isgandarov
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  3. Ahmet Serdar Yilmaz
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  4. Ibrahim Vasi
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  5. Sayyed Hamed Moghanchızadeh
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  6. Fezan Mutlu
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Correspondence to Taner Ulus.

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Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

The study was approved by the Ethics Committee of Eskisehir Osmangazi University, Faculty of Medicine. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All patients were informed about the nature of the study and a written informed consent was obtained.

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Ulus, T., Isgandarov, K., Yilmaz, A.S. et al. Predictors of new-onset atrial fibrillation in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention. Aging Clin Exp Res 30, 1475–1482 (2018). https://doi.org/10.1007/s40520-018-0926-9

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  • DOI: https://doi.org/10.1007/s40520-018-0926-9

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