Development and validation of a risk stratification score for new‐onset atrial fibrillation in STEMI patients undergoing primary percutaneous coronary intervention

Summary Aim New‐onset atrial fibrillation (NOAF) is a complication not infrequent in patients with acute ST‐segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) and has been associated with worse in‐hospital and long‐term prognosis. We aimed to develop and validate a risk score based on common clinical risk factors and routine blood biomarkers to assess the early incidence of NOAF post‐pPCI, before discharge. Methods The risk score for NOAF occurrence during hospitalisation (about 5 days) was developed in a cohort of 1135 consecutive STEMI patients undergoing pPCI while was externally validated in a temporal cohort of 771 STEMI patients. Biomarkers and clinical variables significantly contributing to predicting NOAF were assessed by multivariate Cox‐regression analysis. Results Independent predictors of NOAF were age ≥80 years (6.97 [3.40‐14.30], hazard ratio [95% CI], P 9.68 × 103/μL (2.65 [1.57‐4.48], P 80 ng/L (2.37 [1.13‐4.95], P = .02) and obesity (2.07 [1.09‐3.92], P = .03). By summing the hazard ratios of these predictors we derived the ALBO (acronym derived from: Age, Leucocyte, BNP and Obesity) risk score which yielded high C‐statistics in both the derivation (0.734 [0.675‐0.793], P