Zhao Guojun, Wu Leiming, Liu Yuzhou, Gao Lu, Chen Yang, Yao Rui, Zhang Yanzhou
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China.
Biomed Rep. 2017 Mar;6(3):346-352. doi: 10.3892/br.2017.844. Epub 2017 Jan 17.
The aim of the present study was to assess whether rosuvastatin could reduce the recurrence rate of atrial fibrillation (AF) in patients with heart failure (HF) following catheter ablation (CA). A total of 107 patients with HF and AF who underwent CA of AF by endocardial mapping and radiofrequency between June 2012 and May 2014 were recruited. The patients were randomly divided into three subgroups: i) Administered with 10 mg rosuvastatin daily following ablation (group 1, n=36); ii) administered with 20 mg rosuvastatin daily following ablation (group 2, n=36); and iii) only treated with conventional treatment of HF following ablation (group 3, n=35). After the procedure, patients were followed in the outpatient clinic by interrogation of Holter monitoring. The AF recurrence rate of group 2 was low in comparison with group 1 (22.2% vs. 38.9%, P=0.013) and group 3 (22.2% vs. 48.6%, P=0.021). In comparison with baseline, the parameters of the left ventricular ejection fraction, left atrial diameter (LAD), and the levels of N-terminal pronatriuretic peptide and hypersensitive C-reactive protein (hs-CRP) were all improved in three groups. Furthermore, multivariate analysis demonstrated that LAD [hazard ratio (HR): 1.12, 95% confidence interval (CI): 1.06-1.67, P=0.049], hs-CRP (HR: 1.37, 95% CI: 1.11-1.92, P=0.002) and duration of AF (HR: 1.14, 95% CI: 1.09-1.18, P=0.011) were independent predictors of AF recurrence in patients with HF following CA. Therefore, the present study has demonstrated that treatment with 20 mg rosuvastatin daily following CA was able to significantly decrease the recurrence rate of AF in patients with HF, and LAD, hs-CRP, and duration of AF were independent predictors of AF recurrence in patients with HF following CA. In conclusion, the present study has also demonstrated that CA may improve cardiac function in patients with HF and AF.
本研究的目的是评估瑞舒伐他汀是否能降低心力衰竭(HF)患者导管消融(CA)术后心房颤动(AF)的复发率。招募了2012年6月至2014年5月期间通过心内膜标测和射频进行AF消融的107例HF合并AF患者。患者被随机分为三个亚组:i)消融后每日服用10 mg瑞舒伐他汀(第1组,n = 36);ii)消融后每日服用20 mg瑞舒伐他汀(第2组,n = 36);iii)消融后仅接受HF的常规治疗(第3组,n = 35)。术后,通过动态心电图监测在门诊对患者进行随访。与第1组(22.2%对38.9%,P = 0.013)和第3组(22.2%对48.6%,P = 0.021)相比,第2组的AF复发率较低。与基线相比,三组患者的左心室射血分数、左心房直径(LAD)、N末端脑钠肽前体水平和超敏C反应蛋白(hs-CRP)均有所改善。此外,多因素分析表明,LAD[风险比(HR):1.12,95%置信区间(CI):1.06 - 1.67,P = 0.049]、hs-CRP(HR:1.37,95%CI:1.11 - 1.92,P = 0.002)和AF持续时间(HR:1.14,95%CI:1.09 - 1.18,P = 0.011)是CA术后HF患者AF复发的独立预测因素。因此,本研究表明,CA术后每日服用20 mg瑞舒伐他汀能够显著降低HF患者AF的复发率,且LAD、hs-CRP和AF持续时间是CA术后HF患者AF复发的独立预测因素。总之,本研究还表明,CA可能改善HF合并AF患者的心脏功能。