Objective:

To examine the association of left atrial diameter (LAD), red cell distribution width (RDW-CV), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) with persistent atrial fibrillation (AF) in high-altitude settings.

Approach:

• Study Design: Retrospective case-control analysis involving 4,244 patients with persistent AF and 883 healthy controls.
• Population: Patients diagnosed with persistent AF at Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital from January 2019 to June 2021.
• Data Analysis: Evaluation of factors associated with AF, stratification into middle-altitude and high-altitude groups, and comparison of cardiac and hematological parameters.

Key Findings:

• LAD, NT-proBNP, and RDW-CV were identified as independent factors associated with AF (odds ratio (OR), 95% confidence interval (CI) = 1.014–1.241, 1.002–1.010, 1.282–1.655; p < 0.05).
• Significant differences in NT-proBNP levels were observed among different ethnic groups at middle altitude (p < 0.05).
• In the high-altitude group, significant differences in RDW-CV were noted (p < 0.05).

Interpretation:

LAD has a consistent association with AF across different altitudes and ethnic groups.

Limitations:

• Retrospective design may introduce selection bias.
• Findings may not be generalizable to populations outside of high-altitude settings.

Conclusion:

LAD, NT-proBNP, and RDW-CV are associated with AF in high-altitude populations.