The Incidence and Risk Factor of Atrial Fibrillation After Percutaneous Coronary Intervention

Background Patients with coronary artery disease and atrial fibrillation (AF) have poor clinical outcomes. However, the incidence of new-onset AF occurring after hospital discharge following percutaneous coronary intervention (PCI) has not been well characterized. The aim of this study was to investigate the incidence and risk factors of AF developing after PCI discharge. Methods Patients undergoing PCI enrolled from January 2013 to December 2013. The primary endpoint was new-onset AF occurring after hospital discharge following PCI, defined as AF documented during follow-up and not present during the index PCI hospitalization. Cox proportional hazards regression models with covariate adjustments, complemented by Fine-Gray competing risk analyses, were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for assessing AF risk factors. Results A total of 8,367 patients were included. Among them, 94 (1.1%) patients developed new-onset AF during the 3-year follow-up period. There is no significant difference in the incidence of acute and chronic coronary syndrome (1.1% vs. 1.2%, P = 0.59). Age > 56.5 years old (HR, 2.97; 95%CI, 1.72–5.12, P < 0.001) and PCI history (HR, 1.73; 95%CI, 1.13–2.65, P = 0.013) were identified as independent risk factors for new-onset AF during the follow-up period. Based on these factors, the Postoperative Atrial Fibrillation score, CHA2DS2-VASc score, and Atrial Fibrillation Risk Index were recalibrated, leading to improved model performance. Conclusions This study reported the incidence of new-onset AF after PCI and identified two significant risk factors. Adjusting existing models based on these factors resulted in improved predictive performance. These findings highlight the value of incorporating new risk factors into clinical models to enhance their accuracy and inform better patient management.