{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:09:39Z","timestamp":1777864179159,"version":"3.51.4"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association of serum N-terminal pro-brain natriuretic peptide (NT-proBNP), red cell distribution width (RDW), homocysteine (Hcy), and clinical parameters with new-onset atrial fibrillation (NOAF) in elderly patients with acute myocardial infarction (AMI), and to identify potential risk factors in an exploratory analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective exploratory study enrolled 204 elderly AMI patients (January 2020\u2014December 2022), divided into NOAF (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941) and non-NOAF (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009163) groups. Clinical and laboratory data were collected. LASSO regression was used for initial feature selection from candidate variables. Multivariate logistic regression was then employed to identify factors associated with NOAF. A nomogram was constructed to visualize the risk factor model. Given the exploratory nature and limited number of events (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941), model performance metrics including area under the ROC curve (AUC), calibration, and decision curve analysis were evaluated with caution, accompanied by internal validation using 1,000 bootstrap resamples to assess overfitting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences were found between the NOAF and non-NOAF groups in gender, smoking status, hospitalization duration, Killip class, NT-proBNP, RDW, and Hcy (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). LASSO regression identified six key predictors: gender, hospitalization duration, Killip class, NT-proBNP, RDW, and Hcy. Multivariate logistic regression confirmed these as independent risk factors: female gender (OR\u2009=\u20093.367, 95% CI: 1.193\u20139.498), longer hospitalization duration (OR\u2009=\u20091.110 per day, 95% CI: 1.021\u20131.206), Killip class II-IV (OR\u2009=\u20093.171, 95% CI: 1.157\u20138.689), higher NT-proBNP (OR\u2009=\u20094.677 per ng\/mL increase, 95% CI: 1.774\u201312.328), higher RDW (OR\u2009=\u20091.358 per % increase, 95% CI: 1.163\u20131.585), and higher Hcy (OR\u2009=\u20091.814 per \u00b5mol\/L increase, 95% CI: 1.414\u20132.328); all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05. The model showed good fit (Hosmer-Lemeshow\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2\u2009=\u20096.957,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.541). The final combined nomogram model achieved an AUC of 0.926 (95% CI: 0.880\u20130.973) in the development set. Internal validation via 1,000 bootstrap resamples yielded an optimism-corrected AUC of 0.901. Calibration was assessed visually and statistically (Hosmer\u2013Lemeshow\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2\u2009=\u20096.957,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.541), showing good agreement between predicted and observed risks (Figure 4). Internal validation indicated good calibration (Cox-Snell R\u00b2\u2009=\u20090.593, Nagelkerke R\u00b2\u2009=\u20090.376), and decision curve analysis confirmed a high net clinical benefit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This exploratory study identifies gender, hospitalization duration, Killip class, NT-proBNP, RDW, and Hcy as factors significantly associated with NOAF in elderly AMI patients. However, due to the modest sample size, low events-per-variable ratio, and lack of external validation, these findings should be considered hypothesis-generating. The proposed model is not ready for clinical application. Further validation in larger, prospective cohorts is essential to confirm these associations and to develop a robust predictive tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1744533","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:37:45Z","timestamp":1777527465000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring risk factors for new-onset atrial fibrillation in elderly patients with myocardial infarction based on serum NT-proBNP, RDW, Hcy, and clinical parameters: an exploratory study using LASSO-logistic regression"],"prefix":"10.3389","volume":"13","author":[{"given":"Qun","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jichun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianghai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Affiliated Hospital of the Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"515","DOI":"10.5551\/jat.63574","article-title":"Lipid levels and new-onset atrial fibrillation in patients with acute myocardial infarction","volume":"30","author":"Liu","year":"2023","journal-title":"J Atheroscler Thromb"},{"key":"B2","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1186\/s12872-024-04358-0","article-title":"Association between stress hyperglycemia ratio and mortality in acute myocardial infarction patients with and without atrial fibrillation:a retrospective cohort study from the MIMIC-IV database","volume":"24","author":"Huang","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"B3","doi-asserted-by":"publisher","first-page":"410","DOI":"10.5543\/tkda.2021.96533","article-title":"Atrial fibrillation-related acute myocardial infarction and acute mesenteric ischemia","volume":"49","author":"Pay","year":"2021","journal-title":"Turk Kardiyol Dern Ars"},{"key":"B4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s40256-020-00403-3","article-title":"Double or triple antithrombotic treatment in atrial fibrillation patients with acute myocardial infarction undergoing percutaneous coronary intervention","volume":"21","author":"Benetou","year":"2021","journal-title":"Am J Cardiovasc Drugs"},{"key":"B5","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1111\/echo.15574","article-title":"Predicting new onset atrial fibrillation post acute myocardial infarction:echocardiographic assessment of left atrial size","volume":"40","author":"Lancini","year":"2023","journal-title":"Echocardiography"},{"key":"B6","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1093\/ehjcvp\/pvac070","article-title":"Design and rationale of randomized evaluation of decreased usage of beta-blockers after acute myocardial infarction(REDUCE-AMI)","volume":"9","author":"Yndigegn","year":"2023","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"B7","doi-asserted-by":"publisher","first-page":"338","DOI":"10.3390\/medicina58030338","article-title":"Use of anticoagulant therapy in patients with acute myocardial infarction and atrial fibrillation","volume":"58","author":"Lasica","year":"2022","journal-title":"Medicina(Kaunas)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2021.210808","article-title":"Positive relationship of RDW with NT-proBNP and cTnI in acute myocardial infarction patients","volume":"68","author":"Shen","year":"2022","journal-title":"Clin Lab"},{"key":"B9","first-page":"4561","article-title":"The correlation of the peripheral blood NT-proBNP and NF-\u03baB expression levels with the myocardial infarct area and the post-treatment no-reflow in acute myocardial infarction patients","volume":"13","author":"Zhang","year":"2021","journal-title":"Am J Transl Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"4182","DOI":"10.62347\/VQWS9174","article-title":"Prognostic value of NT-proBNP and uric acid in acute ST-segment elevation myocardial infarction patients after complete revascularization","volume":"16","author":"Kang","year":"2024","journal-title":"Am J Transl Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"14800","DOI":"10.3390\/ijms232314800","article-title":"Circulating levels of ferritin, RDW, PTLs as predictive biomarkers of postoperative atrial fibrillation risk after cardiac surgery in extracorporeal circulation","volume":"23","author":"Altieri","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B12","doi-asserted-by":"publisher","first-page":"973","DOI":"10.3760\/cma.j.cn121430-20200917-00633","article-title":"Relationship between 25-hydroxyvitamin D and infarction volume in patients with acute ischemic stroke in anterior circulation","volume":"33","author":"Liu","year":"2021","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2049","DOI":"10.21037\/jtd-24-170","article-title":"Associations between waist circumference, central obesity, and the presence of non-valvular atrial fibrillation patients with heart failure","volume":"16","author":"Wang","year":"2024","journal-title":"J Thorac Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur Heart J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.3760\/cma.j.cn112138-20230131-00043","article-title":"Application of the Chinese expert consensus on diabetes classification in clinical practice","volume":"62","author":"Yang","year":"2023","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"B16","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1038\/hr.2012.56","article-title":"Japanese Society of hypertension committee for guidelines for self-monitoring of blood pressure at home. The Japanese society of hypertension guidelines for self-monitoring of blood pressure at home(second edition)","volume":"35","author":"Imai","year":"2012","journal-title":"Hypertens Res"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"Peer review committee members.2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation:a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1056\/NEJMoa2401479","article-title":"Beta-Blockers after myocardial infarction and preserved ejection fraction","volume":"390","author":"Yndigegn","year":"2024","journal-title":"N Engl J Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12968\/hmed.2020.0584","article-title":"The interplay between atrial fibrillation and acute myocardial infarction","volume":"82","author":"El-Shetry","year":"2021","journal-title":"Br J Hosp Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1007\/s11886-024-02040-7","article-title":"Atrial fibrillation complicating acute myocardial infarction:prevalence, impact, and management considerations","volume":"26","author":"Sadat","year":"2024","journal-title":"Curr Cardiol Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e021417","DOI":"10.1161\/JAHA.121.021417","article-title":"CREDO-Kyoto AMI registry wave-2 investigators. Newly diagnosed atrial fibrillation in acute myocardial infarction","volume":"10","author":"Obayashi","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"B22","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1161\/CIRCULATIONAHA.124.072156","article-title":"Evidence-Based application of natriuretic peptides in the evaluation of chronic heart failure with preserved ejection fraction in the ambulatory outpatient setting","volume":"151","author":"Reddy","year":"2025","journal-title":"Circulation"},{"key":"B23","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1186\/s12872-024-04326-8","article-title":"Construction and validation of a nomogram prediction model for the risk of new-onset atrial fibrillation following percutaneous coronary intervention in acute myocardial infarction patients","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"B24","first-page":"528","article-title":"Predictive value of NT-proBNP for new-onset atrial fibrillation in the acute phase of myocardial infarction","volume":"30","author":"Dong","year":"2024","journal-title":"Altern Ther Health Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s40292-024-00662-0","article-title":"Red blood cell distribution width is a biomarker of red cell dysfunction associated with high systemic inflammation and a prognostic marker in heart failure and cardiovascular disease:a potential predictor of atrial fibrillation recurrence","volume":"31","author":"Garc\u00eda-Escobar","year":"2024","journal-title":"High Blood Press Cardiovasc Prev"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e14738","DOI":"10.1111\/ijcp.14738","article-title":"Homocysteine(HCY)levels in patients with atrial fibrillation(AF):a meta-analysis","volume":"75","author":"Dong","year":"2021","journal-title":"Int J Clin Pract"},{"key":"B27","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12938-025-01418-0","article-title":"Clinical value of serum uric acid and homocysteine levels in predicting the occurrence of atrial fibrillation in patients with type 2 diabetes mellitus","volume":"24","author":"Li","year":"2025","journal-title":"Biomed Eng Online"},{"key":"B28","doi-asserted-by":"publisher","first-page":"euae028","DOI":"10.1093\/europace\/euae028","article-title":"Disturbed atrial metabolism, shear stress, and cardiac load contribute to atrial fibrillation after ablation:aXAFA biomolecule study","volume":"26","author":"Chua","year":"2024","journal-title":"Europace"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1931","DOI":"10.1016\/j.cjca.2023.06.415","article-title":"Clinical significance of postoperative atrial fibrillation in hypertrophic cardiomyopathy patients undergoing septal myectomy","volume":"39","author":"Bataiosu","year":"2023","journal-title":"Can J Cardiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"246","DOI":"10.5811\/CPCEM.7227","article-title":"Atrial fibrillation occurring after smoking marijuana:a case report and review of the literature","volume":"8","author":"Unanyan","year":"2024","journal-title":"Clin Pract Cases Emerg Med"},{"key":"B31","doi-asserted-by":"publisher","first-page":"2198","DOI":"10.1016\/j.jacep.2024.06.019","article-title":"Smoking cessation and incident atrial fibrillation in a longitudinal cohort","volume":"10","author":"Teraoka","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"322","DOI":"10.3892\/ol.2025.15068","article-title":"Establishment and validation of a clinical prediction model for colorectal adenoma risk factors","volume":"30","author":"Li","year":"2025","journal-title":"Oncol Lett"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1744533\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:37:48Z","timestamp":1777527468000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1744533\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":32,"alternative-id":["10.3389\/fcvm.2026.1744533"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1744533","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"article-number":"1744533"}}