Risk factors for new-onset atrial fibrillation after percutaneous coronary intervention: a systematic review and meta-analysis

New-onset atrial fibrillation (NOAF) is a clinically important complication after percutaneous coronary intervention (PCI) and has been associated with worse in-hospital and short-term outcomes. However, the reported risk factors for NOAF after PCI remain inconsistent across studies. This systematic review and meta-analysis were performed to comprehensively evaluate factors associated with NOAF after PCI. PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP were systematically searched from database inception to February 10, 2026. Observational studies investigating risk factors for NOAF in patients undergoing PCI were eligible. Study selection, data extraction, and quality assessment were conducted independently by two reviewers. Methodological quality was evaluated using the Newcastle–Ottawa Scale (NOS). Statistical analyses were performed using Stata 15. Pooled effect estimates were calculated as odds ratios (ORs) with 95% confidence intervals (CIs). Eleven cohort studies involving 14,607 PCI-treated patients and 840 NOAF events were included. Older age (OR per 1-year increase = 1.12, 95% CI: 1.06–1.18), lower left ventricular ejection fraction (OR = 1.31, 95% CI 1.03–1.66), larger left atrial diameter (OR = 1.51, 95% CI: 1.17–1.96), elevated NT-proBNP (OR = 1.82, 95% CI 1.45–2.29), elevated C-reactive protein (OR = 1.22, 95% CI 1.04–1.44), and postprocedural no-reflow (OR = 2.26, 95% CI 1.61–3.19) were associated with an increased risk of NOAF. Older age, lower left ventricular ejection fraction, larger left atrial diameter, elevated NT-proBNP, elevated C-reactive protein, and postprocedural no-reflow were associated with a higher risk of NOAF after PCI.