Literature DB >> 25995388

The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation.

Uğur Canpolat1, Kudret Aytemir2, Hikmet Yorgun2, Levent Şahiner2, Ergün Barış Kaya2, Serkan Çay3, Serkan Topaloğlu3, Dursun Aras3, Ali Oto2.   

Abstract

AIMS: Previous studies evidenced that increased monocyte count or activity and lower high-density lipoprotein (HDL) cholesterol levels were associated with more prevalent atrial fibrillation (AF) which attributed to pro-inflammatory and pro-oxidant effects. Monocyte-to-HDL ratio (M/H ratio) is a recently emerged indicator of inflammation and oxidative stress which have been only studied in patients with chronic kidney disease. We aimed to investigate the prognostic impact of M/H ratio on AF recurrence after cryoballoon-based catheter ablation. METHODS AND
RESULTS: A total of 402 patients (43.5% female, age 53.5 ± 10.9 years, and 80.8% paroxysmal AF) with symptomatic AF underwent initial cryoablation procedure. Patients were categorized into quartiles on the basis of their pre-procedural M/H ratio. Post-ablation blanking period was observed for 3 months. At a mean follow-up of 20.6 ± 6.0 months, 95 patients (23.6%) had developed AF recurrence. Atrial fibrillation recurrence rates from the lowest to the highest M/H ratio quartiles were 7.4, 7.4, 16.8, and 68.4%, respectively (P < 0.001). On multivariate Cox regression analysis, the preablation M/H ratio (HR: 1.20, 95% CI: 1.15-1.25, P < 0.001), left atrial diameter, duration of AF history, and early AF recurrence were independent predictors of AF recurrence. Using a cut-off level of 11.48, the pre-ablation M/H ratio predicted AF recurrence during follow-up with a sensitivity of 85% and a specificity of 74%.
CONCLUSION: Elevated pre-ablation M/H ratio was associated with an increased recurrence of AF after cryoballoon-based catheter ablation. Our results support the role of pre-ablation pro-inflammatory and pro-oxidant environment in AF recurrence after ablation therapy but suggest that other factors are also important. Published on behalf of the European Society of Cardiology. All rights reserved.
© The Author 2015. For permissions please email: journals.permissions@oup.com.

Entities:  

Keywords:  Atrial fibrillation; Cryoablation; Monocyte-to-HDL ratio; Recurrence

Mesh:

Substances:

Year:  2015        PMID: 25995388     DOI: 10.1093/europace/euu291

Source DB:  PubMed          Journal:  Europace        ISSN: 1099-5129            Impact factor:   5.214


  27 in total

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