The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation.

IF 3 3区医学 Q1 UROLOGY & NEPHROLOGY

Renal Failure Pub Date : 2025-12-01 Epub Date: 2025-02-23 DOI:10.1080/0886022X.2025.2466824

Wenchao Huang, Luxiang Shang, Yan Luo, Shiqiang Xiong, Shuwei Suo, Zhen Zhang, Hanxiong Liu, Huaxin Sun

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Abstract

Background: The difference between the cystatin C-based eGFR (eGFRcys) and the creatinine-based eGFR (eGFRcr) is associated with the risk of developing atrial fibrillation (AF) risk. However, its impact on AF ablation outcomes is unknown.

Methods: The associations between the baseline eGFR ratio (eGFRcys/eGFRcr) and the risk of experiencing post-ablation endpoints were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. The primary endpoints were AF recurrence and adverse events; the secondary endpoint was rehospitalization.

Results: Among 989 participants (49.2% women; mean age 65.7 years), 313 experienced AF recurrence after a median follow-up of 28 months. After full adjustment for confounding factors, a U-shaped association was observed between eGFR ratio and AF recurrence risk (minimum risk at 0.797). Although a U-shaped trend was observed, there was no statistically significant association between the eGFR ratio and adverse events or rehospitalization. Hazard ratios for AF recurrence, compared to the second quartile, were 1.68 (1.20-2.37) for the first quartile, 1.64 (1.15-2.34) for the third quartile, and 1.96 (1.37-2.80) for the fourth quartile. According to the subgroup analysis, the above association was strongly U-shaped for males and linear for females.

Conclusion: In the AF population, both low and high eGFR ratios were associated with an increased risk of post-ablation AF recurrence.

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房颤患者基于胱抑素C和肌酐的估计GFR比值与消融后预后之间的关系

背景：基于胱抑素c的eGFR （eGFRcys）和基于肌酐的eGFR （eGFRcr）之间的差异与发生房颤（AF）的风险相关。然而，其对房颤消融结果的影响尚不清楚。方法：基线eGFR比率（eGFRcys/eGFRcr）与经历消融后终点风险之间的关系在连续尺度（受限三次样条）上进行评估，并通过使用Cox比例风险回归模型的先验定义的分位数类别进行评估。主要终点为房颤复发和不良事件；次要终点是再住院。结果：989名参与者中，女性49.2%；平均年龄65.7岁)，313例在中位随访28个月后出现房颤复发。在对混杂因素进行充分调整后，eGFR与AF复发风险呈u型相关（最小风险为0.797）。虽然观察到u型趋势，但eGFR比率与不良事件或再住院之间没有统计学上显著的关联。与第二个四分位数相比，房颤复发的风险比为：第一个四分位数为1.68(1.20-2.37)，第三个四分位数为1.64(1.15-2.34)，第四个四分位数为1.96（1.37-2.80）。根据亚组分析，上述关联在男性中呈强烈的u型，在女性中呈线性。结论：在房颤人群中，低和高eGFR比率与房颤消融后复发风险增加相关。

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

Renal Failure 医学-泌尿学与肾脏学

CiteScore

3.90

自引率

13.30%

发文量

374

审稿时长

1 months

期刊介绍： Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.