New-Onset Atrial Fibrillation after Acute Myocardial Infarction and its Relationship to Admission Biomarkers [From the TRIUMPH Registry]

Atrial fibrillation (AF) is an independent predictor of mortality after acute myocardial infarction (AMI). We analyzed the relationship between biomarkers linked to myocardial stretch [NT-pro-brain natriuretic peptide (NT-proBNP)], myocardial damage [Troponin-T (TnT)] and inflammation [high-sensitivity C-reactive protein (hsCRP)] and new-onset AF during AMI to identify patients at high risk for AF. In a prospective multicenter registry of AMI patients from (TRIUMPH), we measured NT-proBNP, TnT, and hsCRP in patients without a history of AF (N=2370). New-onset AF was defined as AF that occurred during the index hospitalization. Hierarchical multivariable logistic regression models were used to determine the association of biomarkers with new-onset AF, after adjusting for other covariates. New-onset AF was documented in 114 AMI patients (4.8%; mean age 58 years; 32% women). For each 2-fold increase in NT-proBNP, there was an 18% increase in the rate of AF (OR 1.18 95% CI 1.03-1.35; p