Objective: This study aims to investigate the correlations between red cell distribution width (RDW), homocysteine (Hcy), lipoprotein(a) [Lp(a)], and left atrial diameter (LAD) measured by echocardiography in newly diagnosed nonvalvular atrial fibrillation (NVAF) (referred to as "new-onset AF") patients and their predictive value for new-onset AF. The findings of this study provide a basis for early clinical identification of the risk of new-onset AF.
Patients and methods: Eighty-nine newly diagnosed NVAF patients (46 males and 43 females) admitted to the Department of Cardiology, First Affiliated Hospital of Nanchang University, from January 2017 to January 2023 were included in the new-onset AF group. Over the same time, 88 sinus rhythm patients (44 males and 44 females) were included in the control group. Data, including demographic information, routine blood test parameters, biochemical indicators, and relevant values from cardiac color Doppler ultrasound, were recorded for all study subjects. Logistic regression analysis was used to explore the clinical characteristics of the indicators mentioned above in patients with new-onset AF. Receiver operating characteristic (ROC) curves were drawn to assess the predictive ability of these indicators for new-onset AF.
Results: Univariate analysis of biochemical indicators revealed differences between the two groups (p<0.05) in RDW, Hcy, and Lp(a). The univariate analysis also revealed differences (p<0.05) in RDW, Lp(a), Hcy, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVST), and left ventricular ejection fraction (LVEF). Multivariable logistic regression analysis identified RDW (OR=2.38, 95% CI: 1.65-3.67), Hcy (OR=1.57, 95% CI: 1.37-1.86), and Lp(a) (OR=1.01, 95% CI: 1.00-1.01) as independent risk factors for the new-onset AF. In the subgroup analysis dichotomizing patients around the LAD cutoff value, the high-LAD group had higher RDW, Hcy, and Lp(a) (13.4 vs. 12.7, 15.0 vs. 10.9, 144.0 vs. 101.3, respectively).
Conclusions: RDW, Hcy, and Lp(a) are elevated in patients with new-onset AF. They are positively correlated with LAD in these patients, indicating their role as risk factors for new-onset AF.