Abstract
Epicardial adipose tissue (EAT) is associated with microvascular obstruction (MVO). However, its association with new-onset atrial arrhythmias after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is unclear. We investigated the correlation of cardiac magnetic resonance (CMR)-measured EAT with MVO and its effect on new-onset atrial arrhythmias after PCI in patients with STEMI. This study employed a single-centre retrospective design. Patients diagnosed with STEMI who underwent CMR after PCI between January 2019 and January 2023 were consecutively included and followed-up regularly. Participants were categorised based on whether they developed new-onset atrial arrhythmia after PCI. In comparison to the non-arrhythmia group, the atrial arrhythmia group exhibited higher values for age, heart rate, peak hs-TnT, peak NT-proBNP, EATV, LAES, LAED, and MVO, alongside reduced LVEF. A positive association was identified between EATV and MVO. Univariate analysis using logistic regression revealed that age, heart rate, hs-TnT level, NT-proBNP level, LVEF, EATV, LAES, LAED, and MVO were significant risk factors for atrial arrhythmia. Multivariate logistic regression analysis further identified age, LAES, EATV, and MVO as independent predictors of atrial arrhythmia. ROC curve analysis produced AUC values of 0.690 for age, 0.584 for LAES, 0.607 for MVO, and 0.769 for EATV. The EATV demonstrated a strong positive relationship with MVO after PCI in patients with STEMI. Age, LAES, EATV, and MVO were independent predictors of new-onset atrial arrhythmias and exhibited substantial prognostic significance.