Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project.



Deng, Hai, Shantsila, Alena, Guo, Pi, Zhan, Xianzhang, Fang, Xianhong, Liao, Hongtao, Liu, Yang, Wei, Wei, Fu, Lu, Wu, Shulin
et al (show 2 more authors) (2018) Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project. Journal of arrhythmia, 34 (6). 617 - 625.

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Abstract

<h4>Background</h4>Biomarkers have been related to the arrhythmia recurrence following catheter ablation (CA) of atrial fibrillation (AF). We hypothesized that concurrent measurement of several biomarkers would additively improve their predictive value.<h4>Methods</h4>One thousand four hundred and ten consecutive AF patients (68% male; 57.2 ± 11.6 years) undergoing CA were enrolled. Baseline characteristics, serum B type brain natriuretic peptide (BNP) and high sensitivity C reactive protein (hsCRP), estimated glomerular filtration rate (eGFR), ablation parameters, arrhythmia data at discharge, 1, 3, 6, and then every 6 months post CA were collected. Follow-up ended when arrhythmia recurred or until 31st December 2016.<h4>Results</h4>Three hundred and sixty-five (25.9%) patients had arrhythmia recurrence post-CA during a mean follow-up of 20.7 ± 8.8 months. BNP, hsCRP, and eGFR levels and their cut-off values of 237.45 pg/mL, 1.6 mg/dL, and 82.5 mL/min/1.73 m<sup>2</sup> were good predictors for AF recurrence (all <i>P</i> < 0.01). On multivariate analysis, increasing BNP and hsCRP, decreasing eGFR, gender, and early recurrence (ER) were independent predictors of AF recurrence (all <i>P</i> < 0.01). Compared to BNP alone, BNP plus eGFR or both eGFR and CRP showed incrementally better predictive values (ROC comparisons, all <i>P</i> < 0.01). Similar findings were evident in the subgroups of patients with paroxysmal or nonparoxysmal AF.<h4>Conclusion</h4>Measurement of BNP, CRP, and eGFR were incrementally additive to clinical risk factors in a cumulative manner to improve prediction of arrhythmia recurrence post-CA of AF. The implications of poor arrhythmia outcome in AF patients with multiple abnormal biomarkers pre-CA procedure may help with patient selection and inform the likelihood of success or the need of more complicated CA procedure(s).

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 17 May 2019 08:31
Last Modified: 05 Oct 2022 23:02
DOI: 10.1002/joa3.12111
Open Access URL: https://doi.org/10.1002/joa3.12111
URI: https://livrepository.liverpool.ac.uk/id/eprint/3041731