Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project
Abstract Background 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. Methods One thousand four hundred and ten con...
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doaj-bd33f7a21cf3484f954afd1d7190817c2020-11-25T02:16:11ZengWileyJournal of Arrhythmia1880-42761883-21482018-12-0134661762510.1002/joa3.12111Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation ProjectHai Deng0Alena Shantsila1Pi Guo2Xianzhang Zhan3Xianhong Fang4Hongtao Liao5Yang Liu6Wei Wei7Lu Fu8Shulin Wu9Yumei Xue10Gregory Y.H. Lip11Institute of Cardiovascular Sciences University of Birmingham Birmingham UKInstitute of Cardiovascular Sciences University of Birmingham Birmingham UKDepartment of Public Health Medical College of Shantou University Shantou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaGuangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou ChinaInstitute of Cardiovascular Sciences University of Birmingham Birmingham UKAbstract Background 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. Methods 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. Results 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 m2 were good predictors for AF recurrence (all P < 0.01). On multivariate analysis, increasing BNP and hsCRP, decreasing eGFR, gender, and early recurrence (ER) were independent predictors of AF recurrence (all P < 0.01). Compared to BNP alone, BNP plus eGFR or both eGFR and CRP showed incrementally better predictive values (ROC comparisons, all P < 0.01). Similar findings were evident in the subgroups of patients with paroxysmal or nonparoxysmal AF. Conclusion 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).https://doi.org/10.1002/joa3.12111atrial fibrillationbiomarkerscatheter ablationrecurrence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hai Deng Alena Shantsila Pi Guo Xianzhang Zhan Xianhong Fang Hongtao Liao Yang Liu Wei Wei Lu Fu Shulin Wu Yumei Xue Gregory Y.H. Lip |
spellingShingle |
Hai Deng Alena Shantsila Pi Guo Xianzhang Zhan Xianhong Fang Hongtao Liao Yang Liu Wei Wei Lu Fu Shulin Wu Yumei Xue Gregory Y.H. Lip Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project Journal of Arrhythmia atrial fibrillation biomarkers catheter ablation recurrence |
author_facet |
Hai Deng Alena Shantsila Pi Guo Xianzhang Zhan Xianhong Fang Hongtao Liao Yang Liu Wei Wei Lu Fu Shulin Wu Yumei Xue Gregory Y.H. Lip |
author_sort |
Hai Deng |
title |
Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project |
title_short |
Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project |
title_full |
Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project |
title_fullStr |
Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project |
title_full_unstemmed |
Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project |
title_sort |
multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: the guangzhou atrial fibrillation project |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 1883-2148 |
publishDate |
2018-12-01 |
description |
Abstract Background 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. Methods 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. Results 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 m2 were good predictors for AF recurrence (all P < 0.01). On multivariate analysis, increasing BNP and hsCRP, decreasing eGFR, gender, and early recurrence (ER) were independent predictors of AF recurrence (all P < 0.01). Compared to BNP alone, BNP plus eGFR or both eGFR and CRP showed incrementally better predictive values (ROC comparisons, all P < 0.01). Similar findings were evident in the subgroups of patients with paroxysmal or nonparoxysmal AF. Conclusion 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). |
topic |
atrial fibrillation biomarkers catheter ablation recurrence |
url |
https://doi.org/10.1002/joa3.12111 |
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