Peak troponin I level predicts new-onset atrial fibrillation in patients with myocardial infarction

Regayip Zehir, Ahmet I Tekkesin, Nahide Haykir, Yalcin Velibey, Edibe B Borklu, Ayca Gumusdag

Abstract


Purpose: We aimed to assess the predictive value of peak troponin I level for the occurrence of new-onset AF in myocardial infarction.

Methods: A total of 1553 patients, who were hospitalized with diagnosis of STEMI and underwent primary PCI, were retrospectively evaluated. New-onset AF was defined as any newly diagnosed AF that occurred during index hospitalization after primary PCI.

Results: New-onset AF was observed in 90 patients (5.8% of the study population). Patients who developed AF were older (56.1 vs. 62.6 years, p <0.001), more often had history of stroke and coronary bypass (4.4% vs. 0.8%, p = 0.001; 7.8% vs. 0.9%, p <0.001, respectively), were more often admitted with Killip class 3 or 4 (38.9% vs. 2.7%, p <0.001) and had a TIMI grade flow <3 after PCI (42.2% vs. 6%, p <0.001), higher C-reactive protein plasma level (8.6 vs. 4.8 mg/L, p <0.001) and a higher peak troponin I level (34.5 vs. 29.4 ng/mL, p = 0.02). On multivariate regression analysis, peak troponin I level (odds ratio, 0.97; 95% confidence interval, 0.95–0.99; p = 0.007) independently predicted AF occurrence.

Conclusion: For the first time, peak troponin I has been demonstrated to be independently correlated with AF development in STEMI patients after primary PCI. A major limitation of our study is lack of other serum biochemical markers for the estimation of infarct size; therefore, prospective, large-scale studies are needed.

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DOI: http://dx.doi.org/10.25011/cim.v39i6.27489

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