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Plasma carbohydrate antigen-125 for prediction of atrial fibrillation recurrence after radiofrequency catheter ablation
BMC Cardiovascular Disorders ( IF 2.1 ) Pub Date : 2021-08-19 , DOI: 10.1186/s12872-021-02207-y
Qingya Wang 1 , Chengjing Dang 1 , Haoyu Liu 2 , Jie Hui 1
Affiliation  

Elevated plasma carbohydrate antigen-125 (CA-125) levels are strongly associated with new-onset atrial fibrillation (AF) and heart failure, but the relationship between plasma CA-125 level and AF recurrence following radiofrequency catheter ablation (RFCA) remains poorly investigated. We aimed to assess whether elevated CA-125 levels are related to long-term AF recurrence following RFCA. Preoperative CA-125 levels were determined in AF patients undergoing initial RFCA. Multivariate-adjusted Cox models were constructed to determine the relationship between CA-125 levels and AF recurrence. Multivariate logistic regression analyses were performed to determine predictors of AF recurrence. Of the 353 enrolled patients, 85 patients (24.1%) had AF recurrence at the 12-month follow-up. These patients had significantly higher baseline CA-125 levels than those without AF recurrence [(18.71 ± 12.63) vs. (11.27 ± 5.40) U/mL, P < 0.001]. The incidence of AF recurrence across quartiles 1–4 of CA-125 was 11.5%, 13.3%, 21.6% and 50.0%, respectively (P-trend < 0.001). The adjusted hazard ratios (aHRs) for AF recurrence across quartiles 1–4 of CA-125 were 1.00 (reference), 1.085 (95% CI, 0.468–2.520), 1.866 (95% CI, 0.867–4.019), and 4.246 (95% CI, 2.113–8.533), respectively (P-trend < 0.001). A similar effect was obtained when CA-125 was studied as continuous data (aHR per unit increase in LnCA-125, 3.225, 95% CI, 2.258–4.606; P < 0.001). When a predefined CA-125 cut-off of 13.75 U/mL was established, patients with CA-125 ≥ 13.75 U/mL had a higher risk of recurrent AF than those with CA-125 < 13.75 U/mL (aHR, 3.540, 95% CI, 2.268–5.525, P < 0.001). Multivariate analysis revealed CA-125, high-sensitivity C-reactive protein, and left atrium anteroposterior diameter as independent risk factors for AF recurrence. Elevated preoperative CA-125 levels are related to a higher risk of AF recurrence and can independently predict AF recurrence following RFCA.

中文翻译:

血浆碳水化合物抗原 125 用于预测射频导管消融后心房颤动复发

血浆碳水化合物抗原 125 (CA-125) 水平升高与新发房颤 (AF) 和心力衰竭密切相关,但血浆 CA-125 水平与射频导管消融 (RFCA) 后 AF 复发之间的关系仍缺乏研究. 我们旨在评估升高的 CA-125 水平是否与 RFCA 后长期 AF 复发有关。在接受初始 RFCA 的 AF 患者中测定术前 CA-125 水平。构建多变量调整的 Cox 模型以确定 CA-125 水平与 AF 复发之间的关系。进行多变量逻辑回归分析以确定房颤复发的预测因素。在纳入的 353 名患者中,85 名患者 (24.1%) 在 12 个月的随访中出现 AF 复发。这些患者的基线 CA-125 水平显着高于无 AF 复发的患者 [(18.71 ± 12.63) 与 (11.27 ± 5.40) U/mL,P < 0.001]。CA-125 的四分位数 1-4 的 AF 复发率分别为 11.5%、13.3%、21.6% 和 50.0%(P 趋势 < 0.001)。CA-125 的第 1-4 个四分位数的 AF 复发的调整风险比 (aHR) 为 1.00(参考)、1.085(95% CI,0.468-2.520)、1.866(95% CI,0.867-4.019)和(4.024)。 95% CI,2.113–8.533),分别为(P 趋势 < 0.001)。当将 CA-125 作为连续数据进行研究时,获得了类似的效果(LnCA-125 每单位增加的 aHR,3.225,95% CI,2.258–4.606;P < 0.001)。当预先确定的 CA-125 临界值为 13.75 U/mL 时,CA-125 ≥ 13.75 U/mL 的患者发生 AF 复发的风险高于 CA-125 < 13.75 U/mL 的患者(aHR,3.540,95% CI,2.268–5.525,P < 0.001)。多变量分析显示 CA-125、高敏 C 反应蛋白和左心房前后径是 AF 复发的独立危险因素。术前 CA-125 水平升高与较高的 AF 复发风险相关,可以独立预测 RFCA 后的 AF 复发。
更新日期:2021-08-19
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