
Figure 1: Study flow chart of patients admitted with acute coronary syndromes (ACS)
Legend: ACS: Acute coronary syndrome CABG: Coronary artery bypass graft surgery AF: Atrial fibrillation
Variable |
Statistics/ Levels |
New-onset AF |
No new-onset AF |
Total |
P-value |
Age |
n |
806 |
9190 |
9996 |
. |
|
Median (IQR) |
72 (64, 79) |
63 (54, 72) |
64 (54, 73) |
<.0001 |
Sex |
Male |
571/806 (70.8) |
6584/9213 (71.5) |
7155/10019 (71.4) |
0.7948 |
Systolic blood pressure (mmHg) |
n |
799 |
9167 |
9966 |
. |
|
Median (IQR) |
138 (117, 156) |
140 (122, 157) |
140 (122, 157) |
0.0085 |
Diastolic blood pressure (mmHg) |
n |
798 |
9159 |
9957 |
. |
|
Median (IQR) |
79 (68, 90) |
80 (70, 90) |
80 (70, 90) |
0.0126 |
Heart rate (per min) |
n |
799 |
9161 |
9960 |
. |
|
Median (IQR) |
83 (70, 104) |
76 (65, 89) |
77 (65, 90) |
<.0001 |
BMI |
n |
527 |
6176 |
6703 |
. |
|
Median (IQR) |
27.6 (24.5, 31.2) |
28 (24.9, 31.9) |
27.9 (24.8, 31.8) |
0.0332 |
Diagnosis |
STEMI |
278/806 (34.5) |
2957/9213 (32.1) |
3235/10019 (32.3) |
<.0001 |
|
NSTEMI |
447/806 (55.5) |
4506/9213 (48.9) |
4953/10019 (49.4) |
. |
|
UA |
81/806 (10) |
1750/9213 (19) |
1831/10019 (18.3) |
. |
Killip class |
1 |
625/806 (77.5) |
8356/9213 (90.7) |
8981/10019 (89.6) |
<.0001 |
|
2 |
129/806 (16) |
661/9213 (7.2) |
790/10019 (7.9) |
. |
|
3 or 4 |
52/806 (6.5) |
196/9213 (2.1) |
248/10019 (2.5) |
. |
Cardiac arrest on admission |
|
57/806 (7.1) |
318/9213 (3.5) |
375/10019 (3.7) |
0.0002 |
Family history of coronary heart disease |
|
221/806 (27.4) |
3153/9213 (34.2) |
3374/10019 (33.7) |
0.0032 |
Hypertension |
|
530/804 (65.9) |
5493/9199 (59.7) |
6023/10003 (60.2) |
0.0001 |
Diabetes |
|
252/806 (31.3) |
2485/9213 (27) |
2737/10019 (27.3) |
0.0033 |
Dyslipidaemia |
|
446/804 (55.5) |
5001/9199 (54.4) |
5447/10003 (54.5) |
0.5845 |
Smoking History |
Never smoked |
324/803 (40.3) |
3226/9190 (35.1) |
3550/9993 (35.5) |
<.0001 |
|
Ex-smoker |
308/803 (38.4) |
3140/9190 (34.2) |
3448/9993 (34.5) |
. |
|
Current smoker |
171/803 (21.3) |
2824/9190 (30.7) |
2995/9993 (30) |
. |
Peripheral arterial disease |
|
67/806 (8.3) |
478/9213 (5.2) |
545/10019 (5.4) |
<.0001 |
Prior MI |
|
218/806 (27) |
2542/9213 (27.6) |
2760/10019 (27.5) |
0.7734 |
Prior heart failure |
|
59/806 (7.3) |
506/9213 (5.5) |
565/10019 (5.6) |
0.0372 |
Previous stroke/transient ischemic attack |
|
83/806 (10.3) |
548/9213 (5.9) |
631/10019 (6.3) |
<.0001 |
Previous deep vein thrombosis/PE |
|
29/806 (3.6) |
307/9213 (3.3) |
336/10019 (3.4) |
0.6745 |
Previous percutaneous coronary intervention |
|
140/806 (17.4) |
1853/9213 (20.1) |
1993/10019 (19.9) |
0.1037 |
Previous coronary artery bypass graft |
|
83/806 (10.3) |
891/9213 (9.7) |
974/10019 (9.7) |
0.5179 |
Chronic renal failure |
|
95/806 (11.8) |
653/9213 (7.1) |
748/10019 (7.5) |
<.0001 |
Previous major bleeding |
|
17/806 (2.1) |
141/9213 (1.5) |
158/10019 (1.6) |
0.1013 |
Grace Risk Score (Fox) |
n |
771 |
8889 |
9660 |
. |
|
Median (IQR) |
128.5 (105.8, 148.2) |
101.1 (81.2, 122.2) |
102.8 (82.7, 124.9) |
<.0001 |
Serum creatinine |
n |
801 |
9156 |
9957 |
. |
|
Median (IQR) |
92 (75, 114) |
83 (70.5, 100) |
84 (71, 101) |
<.0001 |
Initial haemoglobin (g/L) |
n |
794 |
9037 |
9831 |
. |
|
Median (IQR) |
137 (125, 151) |
143 (131, 153) |
142 (130, 153) |
<.0001 |
Table 1: Baseline characteristics of primary patient cohort
Variable |
New-onset AF n (%) n=806 |
No new-onset AF n (%) n=9213 |
Total n (%) |
Test |
P-value |
Pre-hospital aspirin |
345/806 (42.8) |
3465/9213 (37.6) |
3810/10019 (38) |
Rao-Scott |
0.0150 |
Pre-hospital betablocker |
266/806 (33) |
2372/9213 (25.7) |
2638/10019 (26.3) |
Rao-Scott |
0.0003 |
Pre-hospital ACEi |
210/806 (26.1) |
2128/9213 (23.1) |
2338/10019 (23.3) |
Rao-Scott |
0.0603 |
Pre-hospital ARB |
199/806 (24.7) |
1964/9213 (21.3) |
2163/10019 (21.6) |
Rao-Scott |
0.0149 |
Pre-hospital statin |
365/806 (45.3) |
3908/9213 (42.4) |
4273/10019 (42.6) |
Rao-Scott |
0.1757 |
Pre-hospital other lipid lowering drug |
47/806 (5.8) |
599/9213 (6.5) |
646/10019 (6.4) |
Rao-Scott |
0.3841 |
Table 2: Pre-hospitalisation medications in primary patient cohort
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.051 (1.044, 1.059) |
<.0001 |
4941.0576 |
0.735 |
Sex |
M vs F |
1.3 (1.042, 1.621) |
0.0261 |
. |
|
Heart rate (per min) |
|
1.022 (1.018, 1.026) |
<.0001 |
. |
|
Cardiac arrest on admission |
Y vs N |
1.894 (1.294, 2.774) |
0.0086 |
. |
|
Hypertension |
Y vs N |
0.886 (0.742, 1.059) |
0.2007 |
. |
|
Diabetes |
Y vs N |
1.091 (0.924, 1.29) |
0.3238 |
. |
|
Peripheral arterial disease |
Y vs N |
1.027 (0.787, 1.341) |
0.8443 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.201 (0.952, 1.514) |
0.1554 |
. |
|
Chronic renal failure |
Y vs N |
1.02 (0.761, 1.368) |
0.8949 |
. |
|
Current smoker |
Y vs N |
1.021 (0.842, 1.239) |
0.8298 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
1.041 (0.891, 1.216) |
0.6146 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.319 (1.069, 1.627) |
0.0218 |
. |
|
Pre-hospital statin |
Y vs N |
0.787 (0.665, 0.931) |
0.0110 |
. |
|
Killip class |
2 vs 1 |
1.495 (1.206, 1.854) |
0.0064 |
. |
|
|
3 or 4 vs 1 |
1.5 (1.056, 2.132) |
. |
. |
|
Serum creatinine |
|
1.001 (0.999, 1.002) |
0.4303 |
. |
|
Initial haemoglobin (g/L) |
|
1 (0.997, 1.003) |
0.8527 |
. |
|
Table 3: Primary patient cohort: Independent predictors of new-onset AF (Basic clinical characteristics)
Variable | Levels | aOR (95% CI) | P-value | QIC | C-stat (95% CI) |
---|---|---|---|---|---|
Age | 1.052 (1.042, 1.063) | <0.0001 | 2832.7009 | 0.81 (0.789, 0.832) | |
Sex | M vs F | 0.993 (0.731, 1.349) | 0.9634 | . | |
Heart rate (per min) | 1.006 (1.001, 1.012) | 0.0593 | . | ||
Cardiac arrest on admission | Y vs N | 2.336 (1.392, 3.922) | 0.0265 | . | |
Hypertension | Y vs N | 1.028 (0.784, 1.348) | 0.8404 | . | |
Diabetes | Y vs N | 0.976 (0.79, 1.205) | 0.8190 | . | |
Peripheral arterial disease | Y vs N | 1.287 (0.906, 1.827) | 0.1863 | . | |
Previous stroke/transient ischemic attack | Y vs N | 1.186 (0.827, 1.7) | 0.3776 | . | |
Chronic renal failure | Y vs N | 1.055 (0.672, 1.658) | 0.8185 | . | |
Current smoker | Y vs N | 1.085 (0.832, 1.414) | 0.5538 | . | |
Pre-hospital ACE/ARB | Y vs N | 0.876 (0.701, 1.094) | 0.2610 | . | |
Pre-hospital beta-blocker | Y vs N | 1.564 (1.214, 2.015) | 0.0078 | . | |
Pre-hospital statin | Y vs N | 0.771 (0.588, 1.012) | 0.0575 | . | |
Killip class | 2 vs 1 | 1.675 (1.268, 2.214) | 0.0006 | . | |
3 or 4 vs 1 | 2.852 (1.817, 4.475) | . | . | ||
Serum creatinine | 1.001 (0.999, 1.002) | 0.4896 | . | ||
Initial hemoglobin (g/L) | 0.998 (0.992, 1.004) | 0.4888 | . | ||
Cardiac vessel with >=50% stenosis during | Y vs N | 1.032 (0.763, 1.395) | 0.8400 | . | |
Cardiac vessel with >=50% stenosis during cath: LAD | Y vs N | 1.026 (0.802, 1.312) | 0.8390 | . | |
Cardiac vessel with >=50% stenosis during cath: RCA | Y vs N | 1.038 (0.841, 1.281) | 0.7276 | . | |
Cardiac vessel with >=50% stenosis during cath: LCX | Y vs N | 0.959 (0.753, 1.221) | 0.7365 | . | |
CABG | Y vs N | 9.97 (7.62, 13.045) | <0.0001 | . |
Table 4: Patients who underwent coronary angiogram: Independent predictors of new-onset in-hospital AF (Basic clinical characteristics + Disease location + CABG)
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.053 (1.043, 1.063) |
<.0001 |
2823.4413 |
0.811 (0.79, 0.833) |
Sex |
M vs F |
0.978 (0.721, 1.327) |
0.8889 |
. |
|
Heart rate (per min) |
|
1.007 (1.001, 1.012) |
0.0532 |
. |
|
Cardiac arrest on admission |
Y vs N |
2.307 (1.368, 3.891) |
0.0285 |
. |
|
Hypertension |
Y vs N |
1.032 (0.79, 1.349) |
0.8163 |
. |
|
Diabetes |
Y vs N |
0.966 (0.786, 1.187) |
0.7434 |
. |
|
Peripheral arterial disease |
Y vs N |
1.298 (0.912, 1.848) |
0.1753 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.176 (0.821, 1.683) |
0.3986 |
. |
|
Chronic renal failure |
Y vs N |
1.055 (0.673, 1.654) |
0.8195 |
. |
|
Current smoker |
Y vs N |
1.088 (0.827, 1.432) |
0.5512 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
0.874 (0.702, 1.088) |
0.2465 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.575 (1.227, 2.023) |
0.0066 |
. |
|
Pre-hospital statin |
Y vs N |
0.771 (0.591, 1.006) |
0.0523 |
. |
|
Killip class |
2 vs 1 |
1.663 (1.26, 2.193) |
0.0006 |
. |
|
|
3 or 4 vs 1 |
2.846 (1.811, 4.473) |
. |
. |
|
Serum creatinine |
|
1.001 (0.999, 1.002) |
0.5012 |
. |
|
Initial haemoglobin (g/L) |
|
0.998 (0.991, 1.004) |
0.3993 |
. |
|
Disease burden |
Single vs minor |
1.24 (0.889, 1.728) |
0.1233 |
. |
|
|
Double vs minor |
1.478 (1.042, 2.097) |
. |
. |
|
|
Triple vs minor |
1.133 (0.811, 1.584) |
. |
. |
|
CABG |
Y vs N |
10.335 (7.795, 13.703) |
<.0001 |
. |
|
Table 5: Patients who underwent coronary angiogram: Independent predictors of new-onset in-hospital AF (Basic clinical characteristics + Disease burden + CABG)
Variable |
Statistics/ Levels |
Catheterisation |
No Catheterisation |
Total |
Test |
P-value |
Age |
n |
8347 |
1649 |
9996 |
|
. |
|
Median (IQR) |
63 (54, 72) |
71 (59, 81) |
64 (54, 73) |
Wilcox |
<.0001 |
Sex |
M |
6110/8370 (73) |
1045/1649 (63.4) |
7155/10019 (71.4) |
Rao-Scott |
. |
Systolic blood pressure (mmHg) |
n |
8340 |
1626 |
9966 |
|
. |
|
Median (IQR) |
140 (122, 158) |
137 (120, 155) |
140 (122, 157) |
Wilcox |
0.0010 |
Diastolic blood pressure (mmHg) |
n |
8333 |
1624 |
9957 |
|
. |
|
Median (IQR) |
80 (70, 91) |
75 (66, 86) |
80 (70, 90) |
Wilcox |
<.0001 |
Heart rate (per min) |
n |
8332 |
1628 |
9960 |
|
. |
|
Median (IQR) |
76 (65, 90) |
79 (65, 92) |
77 (65, 90) |
Wilcox |
0.0020 |
BMI |
n |
5947 |
756 |
6703 |
|
. |
|
Median (IQR) |
28 (25, 31.9) |
27.4 (24.2, 31.5) |
27.9 (24.8, 31.8) |
Wilcox |
0.0073 |
Diagnosis |
STEMI |
3091/8370 (36.9) |
144/1649 (8.7) |
3235/10019 (32.3) |
Rao-Scott |
. |
|
NSTEMI |
4204/8370 (50.2) |
749/1649 (45.4) |
4953/10019 (49.4) |
Rao-Scott |
. |
|
UA |
1075/8370 (12.8) |
756/1649 (45.8) |
1831/10019 (18.3) |
Rao-Scott |
. |
Killip class |
1 |
7658/8370 (91.5) |
1323/1649 (80.2) |
8981/10019 (89.6) |
Rao-Scott |
<.0001 |
|
2 |
559/8370 (6.7) |
231/1649 (14) |
790/10019 (7.9) |
Rao-Scott |
. |
|
3 or 4 |
153/8370 (1.8) |
95/1649 (5.8) |
248/10019 (2.5) |
Rao-Scott |
. |
Cardiac arrest on admission |
|
297/8370 (3.5) |
78/1649 (4.7) |
375/10019 (3.7) |
Rao-Scott |
0.3276 |
Family history of coronary heart disease |
|
2996/8370 (35.8) |
378/1649 (22.9) |
3374/10019 (33.7) |
Rao-Scott |
. |
Hypertension |
|
4789/8356 (57.3) |
1234/1647 (74.9) |
6023/10003 (60.2) |
Rao-Scott |
<.0001 |
Diabetes |
|
2127/8370 (25.4) |
610/1649 (37) |
2737/10019 (27.3) |
Rao-Scott |
<.0001 |
Dyslipidaemia |
|
4375/8356 (52.4) |
1072/1647 (65.1) |
5447/10003 (54.5) |
Rao-Scott |
<.0001 |
Smoking History |
Never smoked |
2827/8350 (33.9) |
723/1643 (44) |
3550/9993 (35.5) |
Rao-Scott |
<.0001 |
|
Ex-smoker |
2827/8350 (33.9) |
621/1643 (37.8) |
3448/9993 (34.5) |
Rao-Scott |
. |
|
Current smoker |
2696/8350 (32.3) |
299/1643 (18.2) |
2995/9993 (30) |
Rao-Scott |
. |
Peripheral arterial disease |
|
365/8370 (4.4) |
180/1649 (10.9) |
545/10019 (5.4) |
Rao-Scott |
<.0001 |
Prior MI |
|
1905/8370 (22.8) |
855/1649 (51.8) |
2760/10019 (27.5) |
Rao-Scott |
. |
Prior heart failure |
|
312/8370 (3.7) |
253/1649 (15.3) |
565/10019 (5.6) |
Rao-Scott |
<.0001 |
Previous stroke/transient ischemic attack |
|
433/8370 (5.2) |
198/1649 (12) |
631/10019 (6.3) |
Rao-Scott |
<.0001 |
Previous deep vein thrombosis/PE |
|
236/8370 (2.8) |
100/1649 (6.1) |
336/10019 (3.4) |
Rao-Scott |
<.0001 |
Previous percutaneous coronary intervention |
|
1458/8370 (17.4) |
535/1649 (32.4) |
1993/10019 (19.9) |
Rao-Scott |
<.0001 |
Previous coronary artery bypass graft |
|
610/8370 (7.3) |
364/1649 (22.1) |
974/10019 (9.7) |
Rao-Scott |
<.0001 |
Chronic renal failure |
|
450/8370 (5.4) |
298/1649 (18.1) |
748/10019 (7.5) |
Rao-Scott |
. |
Previous major bleeding |
|
109/8370 (1.3) |
49/1649 (3) |
158/10019 (1.6) |
Rao-Scott |
0.0010 |
Grace Risk Score (Fox) |
n |
8121 |
1539 |
9660 |
|
. |
|
Median (IQR) |
101.7 (82.5, 122.2) |
113.4 (84, 140.6) |
102.8 (82.7, 124.9) |
Wilcox |
<.0001 |
Supplementary Table 1: Comparison of patients who underwent coronary angiogram versus patients who did not undergo coronary angiogram (Primary patient cohort)
Variable |
Statistics/ Levels |
New-onset AF |
No new-onset AF |
Total |
Test |
P-value |
Left main disease |
|
100/648 (15.4) |
461/7722 (6) |
561/8370 (6.7) |
Rao-Scott |
<.0001 |
LAD disease |
|
443/648 (68.4) |
4417/7722 (57.2) |
4860/8370 (58.1) |
Rao-Scott |
<.0001 |
RCA disease |
|
385/648 (59.4) |
3769/7722 (48.8) |
4154/8370 (49.6) |
Rao-Scott |
<.0001 |
LCx disease |
|
338/648 (52.2) |
3015/7722 (39) |
3353/8370 (40.1) |
Rao-Scott |
<.0001 |
Vein graft disease |
|
18/648 (2.8) |
213/7722 (2.8) |
231/8370 (2.8) |
Rao-Scott |
0.9732 |
IMA disease |
|
9/648 (1.4) |
61/7722 (0.8) |
70/8370 (0.8) |
Rao-Scott |
0.1722 |
Disease burden |
Minor |
69/648 (10.6) |
1193/7722 (15.4) |
1262/8370 (15.1) |
Rao-Scott |
<.0001 |
|
Single |
165/648 (25.5) |
3037/7722 (39.3) |
3202/8370 (38.3) |
Rao-Scott |
. |
|
Double |
190/648 (29.3) |
2020/7722 (26.2) |
2210/8370 (26.4) |
Rao-Scott |
. |
|
Triple |
224/648 (34.6) |
1472/7722 (19.1) |
1696/8370 (20.3) |
Rao-Scott |
. |
CABG |
|
216/648 (33.3) |
626/7722 (8.1) |
842/8370 (10.1) |
Rao-Scott |
<.0001 |
PCI |
|
268/648 (41.4) |
4617/7722 (59.8) |
4885/8370 (58.4) |
Rao-Scott |
<.0001 |
PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft; LAD, left anterior descending; RCA, right coronary artery; LCX, left circumflex; IMA, internal mammary artery |
Subgroup analyses: Patients who underwent coronary angiogram
Supplementary Table 2: Angiographic and hospital revascularisation characteristics of patients who underwent coronary angiogram
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.054 (1.04, 1.068) |
0.0001 |
1597.7458 |
0.797 (0.764, 0.83) |
Sex |
M vs F |
1.465 (0.971, 2.211) |
0.0738 |
. |
|
Heart rate (per min) |
|
1.038 (1.031, 1.045) |
<.0001 |
. |
|
Cardiac arrest on admission |
Y vs N |
2.514 (1.34, 4.719) |
0.0412 |
. |
|
Hypertension |
Y vs N |
0.633 (0.484, 0.827) |
0.0021 |
. |
|
Diabetes |
Y vs N |
0.993 (0.69, 1.43) |
0.9713 |
. |
|
Peripheral arterial disease |
Y vs N |
0.845 (0.389, 1.837) |
0.6635 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.35 (0.832, 2.191) |
0.2758 |
. |
|
Chronic renal failure |
Y vs N |
1.223 (0.717, 2.086) |
0.4735 |
. |
|
Current smoker |
Y vs N |
1.159 (0.768, 1.749) |
0.5003 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
1.417 (0.997, 2.015) |
0.0650 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.355 (0.925, 1.985) |
0.1308 |
. |
|
Pre-hospital statin |
Y vs N |
0.75 (0.493, 1.142) |
0.2021 |
. |
|
Killip class |
2 vs 1 |
1.269 (0.816, 1.975) |
0.5805 |
. |
|
|
3 or 4 vs 1 |
1.041 (0.493, 2.198) |
. |
. |
|
Serum creatinine |
|
1 (0.998, 1.003) |
0.7412 |
. |
|
Initial haemoglobin (g/L) |
|
0.997 (0.987, 1.007) |
0.4983 |
. |
|
Cardiac vessel with >=50% stenosis during cath: Left main |
Y vs N |
1.462 (0.957, 2.234) |
0.1301 |
. |
|
Cardiac vessel with >=50% stenosis during cath: LAD |
Y vs N |
0.803 (0.599, 1.076) |
0.1449 |
. |
|
Cardiac vessel with >=50% stenosis during cath: RCA |
Y vs N |
0.933 (0.702, 1.239) |
0.6390 |
. |
|
Cardiac vessel with >=50% stenosis during cath: LCX |
Y vs N |
0.977 (0.728, 1.312) |
0.8777 |
. |
|
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; LAD, left anterior descending; RCA, right coronary artery; LCX, left circumflex; aOR, adjusted odds ratio; CI, confidence interval; QIC, quasi-likelihood under the independence model criterion; C-stat: concordance statistic |
Supplementary Table 3: Patients who underwent coronary angiogram: Independent predictors of new-onset AF on admission (Basic clinical characteristics + Disease location)
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.055 (1.04, 1.069) |
0.0001 |
1597.9487 |
0.797 (0.764, 0.829) |
Sex |
M vs F |
1.498 (0.996, 2.252) |
0.0571 |
. |
|
Heart rate (per min) |
|
1.038 (1.031, 1.045) |
<.0001 |
. |
|
Cardiac arrest on admission |
Y vs N |
2.577 (1.385, 4.796) |
0.0354 |
. |
|
Hypertension |
Y vs N |
0.625 (0.477, 0.818) |
0.0019 |
. |
|
Diabetes |
Y vs N |
1.001 (0.696, 1.439) |
0.9959 |
. |
|
Peripheral arterial disease |
Y vs N |
0.866 (0.403, 1.861) |
0.7060 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.326 (0.822, 2.141) |
0.2977 |
. |
|
Chronic renal failure |
Y vs N |
1.221 (0.73, 2.04) |
0.4636 |
. |
|
Current smoker |
Y vs N |
1.165 (0.781, 1.738) |
0.4768 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
1.424 (1.007, 2.015) |
0.0586 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.381 (0.949, 2.011) |
0.1052 |
. |
|
Pre-hospital statin |
Y vs N |
0.758 (0.497, 1.154) |
0.2171 |
. |
|
Killip class |
2 vs 1 |
1.281 (0.822, 1.996) |
0.5694 |
. |
|
|
3 or 4 vs 1 |
1.018 (0.481, 2.155) |
. |
. |
|
Serum creatinine |
|
1 (0.998, 1.003) |
0.7157 |
. |
|
Initial haemoglobin (g/L) |
|
0.997 (0.986, 1.007) |
0.4646 |
. |
|
Disease burden |
Single vs minor |
0.783 (0.517, 1.186) |
0.4774 |
. |
|
|
Double vs minor |
0.806 (0.62, 1.049) |
. |
. |
|
|
Triple vs minor |
0.741 (0.469, 1.17) |
. |
. |
|
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; aOR, adjusted odds ratio; CI, confidence interval; QIC, quasi-likelihood under the independence model criterion; C-stat: concordance statistic |
Supplementary Table 4: Patients who underwent coronary angiogram: Independent predictors of new-onset AF on admission (Basic clinical characteristics + Disease burden)
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.043 (1.034, 1.051) |
<.0001 |
3139.0571 |
0.742 (0.719, 0.766) |
Sex |
M vs F |
1.11 (0.835, 1.475) |
0.4583 |
. |
|
Heart rate (per min) |
|
1.008 (1.003, 1.013) |
0.0230 |
. |
|
Cardiac arrest on admission |
Y vs N |
1.744 (1.129, 2.696) |
0.0627 |
. |
|
Hypertension |
Y vs N |
1.015 (0.793, 1.299) |
0.9075 |
. |
|
Diabetes |
Y vs N |
1.063 (0.853, 1.324) |
0.5884 |
. |
|
Peripheral arterial disease |
Y vs N |
1.205 (0.879, 1.652) |
0.2725 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.147 (0.831, 1.584) |
0.4294 |
. |
|
Chronic renal failure |
Y vs N |
0.98 (0.646, 1.489) |
0.9256 |
. |
|
Current smoker |
Y vs N |
1.039 (0.818, 1.318) |
0.7566 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
0.926 (0.738, 1.161) |
0.5113 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.427 (1.102, 1.847) |
0.0262 |
. |
|
Pre-hospital statin |
Y vs N |
0.764 (0.601, 0.971) |
0.0267 |
. |
|
Killip class |
2 vs 1 |
1.661 (1.257, 2.193) |
0.0010 |
. |
|
|
3 or 4 vs 1 |
2.466 (1.613, 3.769) |
. |
. |
|
Serum creatinine |
|
1 (0.999, 1.002) |
0.4573 |
. |
|
Initial haemoglobin (g/L) |
|
0.998 (0.993, 1.003) |
0.4136 |
. |
|
Cardiac vessel with >=50% stenosis during cath: Left main |
Y vs N |
1.881 (1.368, 2.585) |
0.0048 |
. |
|
Cardiac vessel with >=50% stenosis during cath: LAD |
Y vs N |
1.559 (1.218, 1.995) |
0.0032 |
. |
|
Cardiac vessel with >=50% stenosis during cath: RCA |
Y vs N |
1.41 (1.156, 1.72) |
0.0026 |
. |
|
Cardiac vessel with >=50% stenosis during cath: LCX |
Y vs N |
1.344 (1.089, 1.659) |
0.0120 |
. |
|
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; LAD, left anterior descending; RCA, right coronary artery; LCX, left circumflex; aOR, adjusted odds ratio; CI, confidence interval; QIC, quasi-likelihood under the independence model criterion; C-stat: concordance statistic |
Supplementary Table 5: Patients who underwent coronary angiogram: Independent predictors of new-onset in-hospital AF (Basic clinical characteristics + Disease location)
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.043 (1.035, 1.052) |
<.0001 |
3138.1817 |
0.738 (0.715, 0.762) |
Sex |
M vs F |
1.114 (0.836, 1.483) |
0.4432 |
. |
|
Heart rate (per min) |
|
1.008 (1.003, 1.014) |
0.0202 |
. |
|
Cardiac arrest on admission |
Y vs N |
1.753 (1.127, 2.726) |
0.0632 |
. |
|
Hypertension |
Y vs N |
1.002 (0.785, 1.278) |
0.9893 |
. |
|
Diabetes |
Y vs N |
1.065 (0.862, 1.316) |
0.5610 |
. |
|
Peripheral arterial disease |
Y vs N |
1.224 (0.893, 1.678) |
0.2363 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.149 (0.836, 1.579) |
0.4189 |
. |
|
Chronic renal failure |
Y vs N |
0.963 (0.639, 1.452) |
0.8565 |
. |
|
Current smoker |
Y vs N |
1.03 (0.806, 1.316) |
0.8119 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
0.925 (0.742, 1.155) |
0.4992 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.441 (1.119, 1.858) |
0.0208 |
. |
|
Pre-hospital statin |
Y vs N |
0.764 (0.6, 0.973) |
0.0272 |
. |
|
Killip class |
2 vs 1 |
1.636 (1.24, 2.158) |
0.0011 |
. |
|
|
3 or 4 vs 1 |
2.447 (1.605, 3.732) |
. |
. |
|
Serum creatinine |
|
1.001 (0.999, 1.002) |
0.4137 |
. |
|
Initial haemoglobin (g/L) |
|
0.998 (0.993, 1.004) |
0.3589 |
. |
|
Disease burden |
Single vs minor |
1.283 (0.894, 1.841) |
<.0001 |
. |
|
|
Double vs minor |
2.243 (1.577, 3.191) |
. |
. |
|
|
Triple vs minor |
3.346 (2.394, 4.676) |
. |
. |
|
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; aOR, adjusted odds ratio; CI, confidence interval; QIC, quasi-likelihood under the independence model criterion; C-stat: concordance statistic |
Supplementary Table 6: Patients who underwent coronary angiogram: Independent predictors of new-onset in-hospital AF (Basic clinical characteristics + Disease burden)
|
Left main |
LAD |
RCA |
LCx |
Total Effect |
0.040 |
0.022 |
0.013 |
0.013 |
|
[0.018, 0.061] |
[0.012, 0.032] |
[0.004, 0.024] |
[0.004, 0.025] |
|
p ≤ 0.001 |
p ≤ 0.001 |
p = 0.004 |
p = 0.006 |
ACME |
0.039 |
0.021 |
0.011 |
0.015 |
|
[0.028, 0.048] |
[0.017, 0.025] |
[0.010, 0.017] |
[0.012, 0.021] |
|
p ≤ 0.001 |
p ≤ 0.001 |
p ≤ 0.001 |
p ≤ 0.001 |
ADE |
0.002 |
0.001 |
0.002 |
-0.002 |
|
[-0.015, 0.018] |
[-0.009, 0.012] |
[-0.009, 0.012] |
[-0.012, 0.009] |
|
p = 0.906 |
p = 0.818 |
p = 0.688 |
p = 0.736 |
Prop. Mediated |
0.961 |
0.944 |
0.868 |
1.128 |
|
[0.681, 1.800] |
[0.605, 1.716] |
[0.509, 2.687] |
[0.622, 3.730] |
|
p ≤ 0.001 |
p ≤ 0.001 |
p = 0.004 |
p = 0.006 |
Supplementary Table 7: Casual mediation analysis (CABG as a mediator between disease location and new-onset AF)
ACME, Average Causal Mediation Effect; ADE, Average Direct Effect; Prop mediated, Proportion Mediated; LAD, left anterior descending; RCA, right coronary artery; LCX, left circumflex.
|
Single vessel |
Double vessel |
Triple vessel |
Total Effect |
0.009 |
0.036 |
0.059 |
|
[-0.002, 0.019] |
[0.019, 0.048] |
[0.042, 0.079] |
|
p = 0.136 |
p ≤ 0.001 |
p ≤ 0.001 |
ACME |
0.002 |
0.018 |
0.053 |
|
[0.000, 0.005] |
[0.010, 0.022] |
[0.040, 0.071] |
|
p = 0.050 |
p ≤ 0.001 |
p ≤ 0.001 |
ADE |
0.007 |
0.018 |
0.006 |
|
[-0.005, 0.017] |
[0.001, 0.032] |
[-0.016, 0.029] |
|
p = 0.246 |
p = 0.028 |
p = 0.598 |
Prop. Mediated |
0.25 |
0.493 |
0.898 |
|
[-1.507, 2.291] |
[0.272, 0.926] |
[0.601, 1.350] |
|
p = 0.178 |
p ≤ 0.001 |
p ≤ 0.001 |
Supplementary Table 8: Casual mediation analysis (CABG as a mediator between disease burden and new-onset AF)
ACME, Average Causal Mediation Effect; ADE, Average Direct Effect; Prop mediated, Proportion Mediated.
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.059 (1.048, 1.069) |
<.0001 |
2848.8086 |
0.764 (0.74, 0.788) |
Sex |
M vs F |
1.068 (0.826, 1.382) |
0.6090 |
. |
|
Heart rate (per min) |
|
1.025 (1.019, 1.031) |
<.0001 |
. |
|
Cardiac arrest on admission |
Y vs N |
2.628 (1.645, 4.198) |
0.0043 |
. |
|
Hypertension |
Y vs N |
0.701 (0.583, 0.843) |
0.0021 |
. |
|
Diabetes |
Y vs N |
1.046 (0.821, 1.332) |
0.7195 |
. |
|
Peripheral arterial disease |
Y vs N |
0.828 (0.478, 1.434) |
0.4970 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.074 (0.717, 1.609) |
0.7338 |
. |
|
Chronic renal failure |
Y vs N |
1.218 (0.83, 1.787) |
0.3551 |
. |
|
Current smoker |
Y vs N |
1.143 (0.863, 1.513) |
0.3737 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
1.058 (0.822, 1.363) |
0.6581 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.624 (1.131, 2.332) |
0.0173 |
. |
|
Pre-hospital statin |
Y vs N |
0.697 (0.512, 0.947) |
0.0242 |
. |
|
Killip class |
2 vs 1 |
1.466 (1.104, 1.948) |
0.0066 |
. |
|
|
3 or 4 vs 1 |
2.262 (1.418, 3.607) |
. |
. |
|
Serum creatinine |
|
1.001 (1, 1.003) |
0.2106 |
. |
|
Initial haemoglobin (g/L) |
|
0.996 (0.988, 1.005) |
0.2690 |
. |
|
Cardiac vessel with >=50% stenosis during cath: Left main |
Y vs N |
0.972 (0.621, 1.521) |
0.9009 |
. |
|
Cardiac vessel with >=50% stenosis during cath: LAD |
Y vs N |
0.949 (0.8, 1.126) |
0.5437 |
. |
|
Cardiac vessel with >=50% stenosis during cath: RCA |
Y vs N |
1.097 (0.87, 1.384) |
0.4267 |
. |
|
Cardiac vessel with >=50% stenosis during cath: LCX |
Y vs N |
1.066 (0.91, 1.249) |
0.4373 |
. |
|
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; LAD, left anterior descending; RCA, right coronary artery; LCX, left circumflex; aOR, adjusted odds ratio; CI, confidence interval; QIC, quasi-likelihood under the independence model criterion; C-stat: concordance statistic |
Sensitivity analyses: Coronary angiogram patients who did not undergo CABG
Supplementary Table 9: Coronary angiogram patients without CABG: Independent predictors of new-onset AF (Basic clinical characteristics + Disease location)
Variable |
Levels |
aOR (95% CI) |
P-value |
QIC |
C-stat (95% CI) |
Age |
|
1.059 (1.049, 1.07) |
<.0001 |
2845.0239 |
0.764 (0.74, 0.788) |
Sex |
M vs F |
1.066 (0.823, 1.382) |
0.6202 |
. |
|
Heart rate (per min) |
|
1.025 (1.019, 1.03) |
<.0001 |
. |
|
Cardiac arrest on admission |
Y vs N |
2.63 (1.646, 4.201) |
0.0042 |
. |
|
Hypertension |
Y vs N |
0.701 (0.583, 0.843) |
0.0023 |
. |
|
Diabetes |
Y vs N |
1.051 (0.825, 1.339) |
0.6903 |
. |
|
Peripheral arterial disease |
Y vs N |
0.843 (0.484, 1.469) |
0.5435 |
. |
|
Previous stroke/transient ischemic attack |
Y vs N |
1.064 (0.713, 1.588) |
0.7629 |
. |
|
Chronic renal failure |
Y vs N |
1.223 (0.835, 1.79) |
0.3460 |
. |
|
Current smoker |
Y vs N |
1.156 (0.874, 1.53) |
0.3334 |
. |
|
Pre-hospital ACE/ARB |
Y vs N |
1.06 (0.825, 1.362) |
0.6446 |
. |
|
Pre-hospital betablocker |
Y vs N |
1.627 (1.13, 2.343) |
0.0177 |
. |
|
Pre-hospital statin |
Y vs N |
0.696 (0.512, 0.947) |
0.0235 |
. |
|
Killip class |
2 vs 1 |
1.47 (1.108, 1.951) |
0.0057 |
. |
|
|
3 or 4 vs 1 |
2.275 (1.44, 3.594) |
. |
. |
|
Serum creatinine |
|
1.001 (1, 1.002) |
0.2083 |
. |
|
Initial haemoglobin (g/L) |
|
0.996 (0.987, 1.005) |
0.2532 |
. |
|
Disease burden |
Single vs minor |
0.982 (0.731, 1.319) |
0.4736 |
. |
|
|
Double vs minor |
1.185 (0.909, 1.544) |
. |
. |
|
|
Triple vs minor |
0.992 (0.752, 1.308) |
. |
. |
|
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; aOR, adjusted odds ratio; CI, confidence interval; QIC, quasi-likelihood under the independence model criterion; C-stat: concordance statistic |
Supplementary Table 10: Coronary angiogram patients without CABG: Independent predictors of new-onset AF (Basic clinical characteristics + Disease burden)
Figure 1: Study flow chart of patients admitted with acute coronary syndromes (ACS)
Legend: ACS: Acute coronary syndrome CABG: Coronary artery bypass graft surgery AF: Atrial fibrillation
Tables at a glance
Figures at a glance