Epicardial adipose tissue may predict new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction.

2021 
BACKGROUND Atrial fibrillation is one of the most common arrhythmias after ST-segment elevation myocardial infarction (STEMI). In recent years, a strong correlation was found between epicardial adipose tissue (EAT) and the development of atrial fibrillation. In addition, EAT has been reported to be a predictor of new-onset atrial fibrillation development in different clinical situations. In this study, we aimed to determine the relationship between EAT thickness in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) and the development of new-onset atrial fibrillation during hospital follow-up. MATERIAL AND METHODS Four hundred and thirteen consecutive patients [284 men (69%) and 129 women (31%)] with a mean age of 59 ± 11 years diagnosed with STEMI were included in this study. Atrial fibrillation developed in 52 (12.5%) patients during in-hospital follow-up and the remaining 361 patients were determined as the control group. There was no difference between the two groups in terms of age and sex. EAT thickness was measured using transthoracic echocardiography. Multiple regression analysis was performed to determine the independent predictors of atrial fibrillation. RESULTS EAT thickness was higher in the group with atrial fibrillation than in the control group (P < 0.001). The SYNTAX risk score was higher in the atrial fibrillation group (P < 0.001). A positive correlation was observed between EAT thickness and SYNTAX score (r = 0.523, P < 0.001). In the logistic regression analysis, EAT was detected to be an independent predictor for the development of atrial fibrillation (odds ratio: 4.135, 95% confidence interval 1.245-8.176, P < 0.001). CONCLUSION EAT thickness is an important marker of atrial fibrillation development in STEMI patients in the post-pPCI period. We think that EAT thickness can be used as a cardioembolic risk factor in STEMI patients.
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