ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Epidemiology and Prevention
Elevated plasma cancer antigen-125 level is associated with increased risk of new-onset atrial fibrillation after acute myocardial infarction
Provisionally accepted
- Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
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Background: New-onset atrial fibrillation (NOAF) is the most commonly encountered arrhythmia during the course of acute myocardial infarction (AMI) that related to worse prognosis independently. Aims: We aimed to validate the discrimination performance of CA-125 in the prediction of post-AMI NOAF in Chinese population. Methods: 488 consecutive AMI patients from 1 January 2020 to 1 January 2022 without AF history before were enrolled in this study. Risk factors of post-AMI NOAF were determined using univariable and multivariable logistic regression analyses. The ROC curve analyses were used to evaluate the discrimination performance of different parameters and score models. AUCs were compared by Z tests. Results: 48 (9.84%) patients developed post-AMI NOAF during hospitalization. The NOAF group were older and had higher Killip class, BNP, CA-125, LAD, LVESd, CHA2DS2-VASc score, GRACE risk score (RS), in-hospital mortality, and lower LDL, LVEF, initial β-receptor blocker and ACEI/ARB use (P<0.05 vs. no-NOAF group for all measures). In multivariate regression analyses, CA-125 remained as an independent risk factor of post-AMI NOAF in different models. In ROC curve analyses, CA-125 (AUC= 0.753, 95% CI: 0.665–0.84, P<0.001), GRACE RS (AUC= 0.701, 95% CI: 0.593–0.809, P=0.001) and CHA2DS2-VASc score (AUC= 0.644, 95% CI: 0.532– 0.757, P=0.014) were valid tools to predict post-AMI NOAF. After Z tests, the discrimination performance of CA-125 was significantly better than that of the CHA2DS2-VASc score (P=0.038), but no statistical better than that of the GRACE RS (P=0.353). Conclusion: Elevated plasma CA-125 level was independently associated with NOAF after AMI, with high discriminatory performance.
Keywords: acute myocardial infarction, cancer antigen-125, CHA2DS2-VASc score, New-onset atrial fibrillation, Risk score model
Received: 06 Oct 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Fu, Zuo, Chen, Xu and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lin Zhao, zhaolinl666@163.com
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