Predicting New-Onset Atrial Fibrillation in Patients with Arrhythmias Using High-Sensitivity Troponin I

Atrial fibrillation (AF) significantly increases stroke and mortality risk, and while high-sensitivity Troponin I (hs-TnI) is associated with AF in the general population, its predictive value in high-risk groups is unclear. This study investigated whether baseline hs-TnI predicts new-onset AF in patients with pre-existing non-AF arrhythmias. This prospective, single-center, observational study involved 232 patients without a prior history of AF, who were followed for a median of 12 months. Baseline hs-TnI levels were measured, and a multivariate Cox proportional hazards regression model was used to identify independent predictors of new-onset AF/Atrial Flutter (AFL). During fol-low-up, 16 cases (6.9%) of new-onset AF/AFL occurred. Although Kaplan-Meier analy-sis showed a trend, hs-TnI was not found to be an independent predictor in the multi-variate model (HR=1.000, p=0.844). Conversely, the risk of new-onset AF was strongly and independently predicted by Left Atrial (LA) size (HR=1.27, p< 0.001), a history of Diabetes Mellitus (HR=5.99, p=0.006), and a history of Stroke (HR=10.18, p=0.032). In conclusion, baseline hs-TnI does not independently predict the development of new-onset AF in patients with non-AF arrhythmias. Risk stratification in this vulnerable population should instead prioritize established structural changes (LA size) and major systemic comorbidities (Diabetes Mellitus and prior Stroke).