Relation between CRP-Albumin ratio and left atrial volume index for prediction of new onset atrial fibrillation in patients with STEMI treated with percutaneous coronary interventions

New onset atrial fibrillation (NOAF) in the case of acute myocardial infarction appears to be associated with inflammation. However, its influence alongside other risk factors is currently unknown. In this study, the effect of inflammation in predicting NOAF independent of left atrial volume index (LAVi) was investigated with a new marker, the C-reactive protein/Albumin ratio (CAR). We included 945 ST-elevation myocardial infarction (STEMI) patients who underwent pPCI. Two groups were defined according to the presence of NOAF and the groups were compared for demographic, clinical and angiographic findings. Predictors of the NOAF were assessed by multivariable regression analysis. Fifty-five (5.8%) patients had NOAF after the procedures. CAR was substantially higher in patients with NOAF (5.9 [4.9] vs 0.46 [1] p<0.01). CAR was shown as an independent marker for NOAF (OR:1.19 95% CI: 1.11-1.27 p<0.01) development in multivariable regression analysis. In receiver operating curve characteristics, the sensitivity and the specificity of the value CAR>4.2 were 64% and 81% (AUC: 0.86) respectively. In subgroup analysis, OR of CAR in LAVi ≥26.7 ml/m² was 19.5 and 22.1 in LAVi<26.7 ml/m² (p for interaction=0.02). A novel inflammatory marker, CAR has the potential to predict the development of NOAF regardless of LAVi in patients with STEMI treated by PPCI.