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Propensity score matching analysis of the impact of Syntax score and Syntax score II on new onset atrial fibrillation development in patients with ST segment elevation myocardial infarction
Authors:Ibrahim Rencuzogullari MD  Metin Çağdaş MD  Suleyman Karakoyun MD  Mahmut Yesin MD  Mustafa O. Gürsoy MD  İnanç Artaç MD  Doğan İliş MD  Suleyman C. Efe MD  Ibrahim H. Tanboga MD
Affiliation:1. Kars Kafkas University Medical School, Department of Cardiology, Kars, Turkey;2. Kartal kosuyolu Education and Research Center, Department of Cardiology, Istanbul, Turkey;3. Cardiology, Gaziemir State Hospital, Department of Cardiology, ?zmir, Turkey;4. Ataturk Universitesi, Medical School, Department of Cardiology, Erzurum, Turkey
Abstract:

Background

New‐onset atrial fibrillation (NOAF) is a common complication in the setting of ST segment elevation myocardial infarction (STEMI), and worsened short/long‐term prognosis. Several clinical parameters have already been associated with NOAF development. However, relationship between NOAF and coronary artery disease (CAD) severity in STEMI patients is unclear. This study evaluates the relationship between NOAF and CAD severity using Syntax score (SS) and Syntax score II (SSII) in STEMI patients who were treated with primary percutaneous coronary intervention (pPCI).

Method

We enrolled 1,565 consecutive STEMI patients who were treated with pPCI. Patients with NOAF were compared to patients without NOAF in the entire study population and in a matched population defined by propensity score matching.

Results

Patients with NOAF had significantly higher SS and SSII than those without, both in the matched population (18.6 ± 4 vs 16.75 ± 3.6; < .001 and 42 ± 13.4 vs 35.1 ± 13.1; p < .001, respectively), and in all study population (18.6 ± 4 vs 16.5 ± 4.6; p < .001 and 42 ± 13.3 vs 31.5 ± 11.9; p < .001 respectively). SSII, compared to its components, was the only independent predictor of NOAF (OR: 1,041 95% CI: 1.015–1.068; p = .002). In the long‐term follow‐up, all‐cause long‐term mortality was significantly higher in patients with NOAF than those without NOAF (23.3% vs. 11%; p = .032).

Conclusion

This is the first study to comprehensively examine the relationship between NOAF development and CAD severity using SS and SSII. We demonstrated that, in STEMI patients, high SSII was significantly related to NOAF and was an independent predictor of NOAF. Furthermore, patients with NOAF were associated with poor prognosis.
Keywords:atrial fibrillation  ST elevation myocardial infarction  SYNTAX score  SYNTAX score II
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