cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2026-41-2-34-44cardiotomsk-3163Research ArticleОБЗОРЫREVIEWSАнализ точности рискометрических инструментов для прогнозирования новой фибрилляции предсердий при инфаркте миокарда с подъемом сегмента ST после чрескожного коронарного вмешательства (систематический обзор)Analysis of accuracy of risk assessment tools for predicting new-onset atrial fibrillation in ST-elevation myocardial nfarction with percutaneous coronaty intervention (a systematic review)https://orcid.org/0009-0004-3745-5399ПакР. Л.PakR. L.

Пак Регина Леонидовна - старший преподаватель, департамент фундаментальной медицины; младший научный сотрудник, лаборатория анализа больших данных в здравоохранении и медицине, ДВФУ; врач-анестезиолог-реаниматолог, отделение реанимации и интенсивной терапии, Региональный сосудистый центр, ГБУЗ ПККБ № 1.

690091, Приморский край, Владивосток, ул. Алеутская, 57; 690922, Приморский край, Владивосток, о. Русский, пос. Аякс, 10, к. 25

Regina L. Pak - Senior Lecturer, Department of Fundamental Medicine; Junior Research Scientist, Data Analysis Laboratory in Healthcare and Biomedicine, School of Medicine and Life Sciences, FEFU; Intensive Care Physician, Regional Vascular Centre, Regional Clinical Hospital No. 1.

57 Aleutskaya str., 690091, Vladivostok; 10 Ajax Bay, Russky Island, 690922, Vladivostok

nonchalant@bk.ruhttps://orcid.org/0000-0002-9250-557XГельцерБ. И.GeltserB. I.

Гельцер Борис Израйлевич - д-р мед. наук, профессор, чл.-корр. РАН, главный научный сотрудник, НОЦ «Искусственный интеллект», ВВГУ; заместитель директора по научной работе, Школа медицины и наук о жизни, ДВФУ.

690922, Приморский край, Владивосток, о. Русский, пос. Аякс, 10, к. 25; 690014, Приморский край, Владивосток, ул. Гоголя, 41

Boris I. Geltser - Dr. Sci. Med., Professor, Corresponding Member of the Russian Academy of Sciences; Chief Research Scientist, Artificial Intelligence Research and Education Center, VSU; Professor, Department of Clinical Medicine, School of Medicine and Life Sciences, FEFU.

10 Ajax Bay, Russky Island, 690922, Vladivostok; 41, Gogolya str., 690014, Vladivostok

geltserb@gmail.comhttps://orcid.org/0000-0002-8726-0491КокаревЕ. А.KokarevE. A.

Кокарев Евгений Анатольевич - канд. мед. наук, заведующий отделением реанимации и интенсивной терапии, Региональный сосудистый центр, ГБУЗ ПККБ № 1.

690091, Приморский край, Владивосток, ул. Алеутская, 57; 690922, Приморский край, Владивосток, о. Русский, пос. Аякс, 10, к. 25

Evgenii A. Kokarev - Cand. Sci. Med.; Head of the Intensive Care Unit Department, Regional Vascular Centre, Regional Clinical Hospital No. 1.

57 Aleutskaya str., 690091, Vladivostok; 10 Ajax Bay, Russky Island, 690922, Vladivostok

kokareve@yandex.ruhttps://orcid.org/0000-0002-4539-685XШахгельдянК. И.ShakhgeldyanK. I.

Шахгельдян Карина Иосифовна - д-р техн. наук, доцент, директор НОЦ «Искусственный интелект», ВВГУ; заведующий лабораторией анализа больших данных в здравоохранении и медицине, Школа медицины и наук о жизни, ДВФУ.

690922, Приморский край, Владивосток, о. Русский, пос. Аякс, 10, к. 25; 690014, Приморский край, Владивосток, ул. Гоголя, 41

Karina I. Shakhgeldyan - Dr. Sci. Tech., Associate Professor; Head of the Big Data Analysis Laboratory in Medicine and Healthcare, School of Medicine and Life Sciences, FEFU; Director of the Artificial Intelligence Research and Education Center, VSU.

10 Ajax Bay, Russky Island, 690922, Vladivostok; 41, Gogolya str., 690014, Vladivostok

carinashakh@gmail.comhttps://orcid.org/0009-0001-1191-6837СипрашвилиШ. З.SiprashviliSh. Z.

Сипрашвили Шалва Зазавич - ассистент, Школа медицины и наук о жизни, ДВФУ; врач-анестезиолог-реаниматолог, отделение анестезиологии и реанимации, ГБУЗ ПККБ № 1.

690091, Приморский край, Владивосток, ул. Алеутская, 57; 690922, Приморский край, Владивосток, о. Русский, пос. Аякс, 10, к. 25

Shalva Z. Siprashvili - Assistant Professor, Department of Clinical Medicine, FEFU; Intensive Care Physician, Intensive Care Unit Department, Regional Clinical Hospital No. 1.

57 Aleutskaya str., 690091, Vladivostok; 10 Ajax Bay, Russky Island, 690922, Vladivostok

siprashvili88@gmail.comПриморская краевая клиническая больница № 1 (ПККБ № 1); Дальневосточный федеральный университет (ДВФУ)РоссияRegional clinical hospital No.1; Far Eastern Federal University (FEFU)Russian FederationДальневосточный федеральный университет (ДВФУ); Владивостокский государственный университет (ВВГУ)РоссияFar Eastern Federal University (FEFU); Vladivostok State University (VSU)Russian Federation2026090720264123444Copyright © Пак Р.Л., Гельцер Б.И., Кокарев Е.А., Шахгельдян К.И., Сипрашвили Ш.З., 20262026Пак Р.Л., Гельцер Б.И., Кокарев Е.А., Шахгельдян К.И., Сипрашвили Ш.З.Pak R.L., Geltser B.I., Kokarev E.A., Shakhgeldyan K.I., Siprashvili S.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/3163Введение

Введение. Фибрилляция предсердий (ФП) – наиболее распространенное нарушение сердечного ритма, встречающееся у 2–4% взрослого населения. Среди пациентов с инфарктом миокарда (ИМ) с подъемом сегмента ST (ИМпST) частота новой ФП (нФП) варьирует от 4 до 28%. Развитие нФП после чрескожного коронарного вмешательства (ЧКВ) у больных ИМпST связано с повышенным риском госпитальной летальности (ГЛ) и неблагоприятными долгосрочными исходами.

Цель

Цель: оценка прогностического потенциала существующих рискометрических инструментов для прогнозирования нФП у больных ИМпST после ЧКВ.

Методы

Методы. Поиск научной литературы проводился с использованием принципов PRISMA. Были проанализированы данные международных баз данных, таких как PubMed, Web of Science и другие, за период с 2020 по 2025 гг. Включены статьи, посвященные прогнозированию нФП у больных ИМпST после ЧКВ, развившейся в период нахождения в стационаре. В итоговый анализ вошли 23 статьи.

Результаты и обсуждение

Результаты и обсуждение. Частота нФП у пациентов с ИМпST после ЧКВ варьирует от 2,3 до 17%, что свидетельствует о ее значительной вариабельности. Развитие нФП ассоциируется с повышенной ГЛ, которая в 2–3 раза выше у пациентов с нарушениями ритма. Прогностическая точность существующих рискометрических шкал, исходно не предназначенных для оценки риска нФП (CHA2DS2-VASc, HATCH, POAF и др.), не соответствует приемлемому уровню (AUC < 0,7). Прогностическая точность большинства авторских моделей нФП, разработанных на когортах больных ИМпST после ЧКВ, была выше (AUC: 0,758–0,839). Это может объясняться тем, что в качестве предикторов нФП использовались индикаторы системного воспалительного ответа, метаболического и нутритивного статуса больных, косвенно характеризующие тяжесть ишемического повреждения, ремоделирования миокарда и дисбаланса нейрогуморальной регуляции, ассоциированных с риском развития нФП.

Introduction

Introduction. Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring in 2–4% of the adult population. Among patients with ST-elevation myocardial infarction (STEMI), the incidence of new-onset atrial fibrillation (NOAF) ranges from 4 to 28%. The development of NOAF after percutaneous coronary intervention (PCI) in STEMI patients is associated with an increased risk of hospital mortality and adverse long-term outcomes.

Aim

Aim: To assess the prognostic performance of existing risk stratification tools for predicting NOAF in STEMI patients after PCI.

Methods

Methods. A literature search was conducted following the PRISMA guidelines. Data from international databases, including PubMed, Web of Science, and others, published between 2020 and 2025, were analyzed. Studies addressing the prediction of NOAF developing during hospitalization in STEMI patients after PCI were included. A total of 23 articles were selected for the final analysis.

Results and Discussion

Results and Discussion. The reported incidence of NOAF in STEMI patients after PCI ranged from 2.3% to 17%, indicating substantial variability. The occurrence of NOAF was associated with increased in-hospital mortality, which was 2–3 times higher in patients with arrhythmia. The predictive accuracy of existing risk scores not originally designed to assess NOAF risk (including CHA2DS2-VASc, HATCH, POAF, etc.) was insufficient, with AUC < 0.7. In contrast, most NOAF prediction models developed specifically in STEMI cohorts undergoing PCI demonstrated higher discriminative ability (AUC: 0.758–0.839). This superior performance may be explained by the inclusion of predictors reflecting systemic inflammatory response, metabolic and nutritional status, which indirectly characterize the severity of ischemic injury, myocardial remodeling, and neurohumoral imbalance associated with an increased risk of NOAF.

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The authors declare that there are no conflicts of interest present.