Platelet-to-Lymphocyte Ratio as a Predictor of Atrial Fibrillation in STEMI Patients

BACKGROUND Inflammatory response plays an important role in ST-segment elevation myocardial infarction (STEMI) and atrial fibrillation (AF). Platelet-to-lymphocyte ratio (PLR) is a useful biomarker of inflammatory response. However, the relationship between PLR and new-onset AF (NOAF) in STEMI patients remains unclear. This study aimed to assess the value of PLR in forecasting the occurrence of NOAF after percutaneous coronary intervention (PCI) in STEMI patients. MATERIAL AND METHODS This single-center, retrospective, observational study consecutively enrolled patients diagnosed with STEMI between January 2022 to October 2024 who underwent primary PCI. All patients received continuous electrocardiogram monitoring during hospitalization and were grouped according to whether NOAF occurred during hospitalization. Logistic regression analysis was used to determine potential risk factors for NOAF. Restricted cubic spline (RCS) regression analysis was used to explore the dose-response relationship between PLR and NOAF. RESULTS A total of 654 STEMI patients were included in this study, of whom 28.44% were female, with a mean age of 63.37±12.91 years, and the incidence of NOAF during hospitalization was 53/654 (8.1%). After adjusting for potential confounders, multivariate logistic regression analysis showed that left ventricular ejection fraction (OR=0.900, 95% CI: 0.865~0.937, P<0.001), N-terminal pro-B-type natriuretic peptide (OR=1.525, 95% CI: 1.173~1.982, P=0.002), and PLR (OR=1.003, 95% CI: 1.001~1.006, P=0.004) were independent factors influencing the occurrence of NOAF in STEMI patients (P<0.05).The RCS results suggested a linear dose-response relationship between PLR and NOAF (P<0.05). CONCLUSIONS Elevated PLR is an independent risk factor for NOAF after PCI in STEMI patients, and there is a linear dose-response relationship between PLR and NOAF.