Evaluating the Prognostic Significance of Cystatin C Level Variations Pre- and Post-Radiofrequency Catheter Ablation in the Recurrence of Persistent Atrial Fibrillation

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2024-10-16 DOI:10.1111/anec.70024

Yu-Yan Zhang, Ji-Yong Ge, Yuan Ji, Yi Zhu, Zhen-Yan Zhu, Fang-Fang Wang

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引用次数: 0

Abstract

Objective

To investigate the correlation between persistent atrial fibrillation (AF) recurrence and alterations in cystatin C levels pre- and post-radiofrequency catheter ablation (RFCA).

Methods

This study encompassed 114 patients diagnosed with persistent AF. Their serum cystatin C levels were assessed both prior to and 3 months after undergoing an RFCA procedure. The variance in cystatin C levels before and after RFCA is represented as ΔCystatin C. Subsequently, we compared these values between two groups: patients who did not experience a recurrence of AF (n = 79) and those who did experience a recurrence (n = 35).

Results

A significant reduction in cystatin C levels post-RFCA in both groups, with a more pronounced decrease observed in the non-recurrence group. Moreover, the recurrence group exhibited larger left atrial diameter and volume before RFCA compared to the non-recurrence group. Cox regression analysis indicated that smaller reductions in serum cystatin C levels and greater left atrial volumes before RFCA were associated with an increased risk of recurrence, after adjusting for covariates. The receiver operating characteristic curve indicated an elevated probability of clinical recurrence of AF post-RFCA in patients with a cystatin C decline < 0.08 mg/L (AUC 0.64). The Kaplan–Meier survival analysis revealed that patients with a cystatin C decline > 0.08 mg/L exhibited significantly higher rates of remaining free from recurrence following RFCA across a 24-month follow-up period (Log-rank test p = 0.003).

Conclusions

Alterations in ΔCystatin C levels pre and post-RFCA in the initial phase could independently predict the recurrence of AF.

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评估射频导管消融前后胱抑素 C 水平变化对持续性心房颤动复发的预后意义

目的探讨持续性房颤（AF）复发与射频导管消融术（RFCA）前后胱抑素 C 水平变化之间的相关性。方法本研究涵盖 114 名被诊断为持续性房颤的患者。在接受射频导管消融术之前和之后 3 个月，对患者的血清胱抑素 C 水平进行了评估。随后，我们对两组患者的胱抑素 C 水平进行了比较：未复发房颤的患者（79 人）和复发房颤的患者（35 人）。结果两组患者的胱抑素 C 水平在 RFCA 后均明显下降，未复发组的下降更为明显。此外，与未复发组相比，复发组在进行 RFCA 前的左心房直径和容积更大。Cox 回归分析表明，在调整协变量后，RFCA 前血清胱抑素 C 水平降低幅度较小和左心房容积增大与复发风险增加有关。接收器操作特征曲线显示，胱抑素 C 下降大于等于 0.08 毫克/升的患者在 RFCA 后房颤临床复发的概率较高（AUC 0.64）。卡普兰-梅耶生存分析显示，胱抑素 C 下降大于等于 0.08 mg/L 的患者在随访 24 个月后仍未复发的比例明显更高（对数秩检验 p = 0.003）。结论 ΔCystatin C水平在RFCA前后初始阶段的变化可独立预测房颤的复发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.