ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicAdvancements in Understanding and Managing Residual Risk of Coronary Artery DiseasesView all 6 articles
Development and Validation of a Nomogram for Predicting Atrial Fibrillation After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction
Provisionally accepted
- Xinxiang Central Hospital, Xinxiang, China
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Background: Atrial fibrillation (AF) is a frequent complication in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), contributing to adverse outcomes. Early identification of individuals at high risk for post-PCI AF is crucial for tailored monitoring and intervention strategies. This study aimed to develop and validate a predictive nomogram for new-onset AF in AMI patients treated with PCI. Methods: A retrospective observational cohort of 268 AMI patients undergoing PCI between January 2023 and December 2024 was analyzed. Patients were divided into AF (n=56) and non-AF (n=212) groups based on documented AF within six months post-PCI. Baseline clinical, echocardiographic, laboratory, and procedural variables were collected. Multivariate logistic regression was used to identify independent predictors of post-PCI AF. A nomogram was constructed based on the final model. Discriminatory performance was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was evaluated using the Hosmer–Lemeshow test and internal bootstrap validation. Results: Six independent predictors were identified: Gensini score, left atrial diameter, serum creatinine (SCr), prognostic nutritional index (PNI), symptom onset-to-PCI time, and post-PCI thrombolysis in myocardial infarction (TIMI) flow grade. The resulting nomogram demonstrated excellent discrimination (AUC = 0.916) and strong calibration (Hosmer–Lemeshow χ² = 0.967, p = 0.551; optimism-corrected C-index = 0.909). The model showed good internal validity and potential clinical utility for early risk stratification. Conclusions: This study identified Gensini score, left atrial diameter, SCr, PNI, onset-to-PCI time, and final TIMI flow grade as independent predictors of post-PCI AF, and developed a nomogram with excellent predictive accuracy requiring validation in larger multicenter cohorts.
Keywords: acute myocardial infarction, Atrial Fibrillation, Percutaneous Coronary Intervention, nomogram, RiskPrediction
Received: 18 Sep 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Li, Liu, Tian, Lu 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: Li-Pei Zhao
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