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循环半乳糖凝集素 3 与导管消融术后心房颤动复发:一项荟萃分析。

Circulating Galectin-3 and Atrial Fibrillation Recurrence after Catheter Ablation: A Meta-Analysis.

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Cardiovasc Ther. 2019 Apr 2;2019:4148129. doi: 10.1155/2019/4148129. eCollection 2019.

Abstract

BACKGROUND

Galectin-3 (Gal-3) is involved in fibrosis and heart failure. However, epidemiological studies evaluating the association between Gal-3 and atrial fibrillation (AF) recurrence after catheter ablation showed inconsistent results. We conducted a meta-analysis to comprehensively evaluate the relationship between baseline circulating Gal-3 levels and AF recurrence in patients undergoing catheter ablation.

METHODS

Relevant studies were identified by systematically searching the PubMed and Embase databases. A random-effect model was used to synthesize the results. Sensitivity analyses, performed by omitting one study at a time, were used to evaluate the robustness of the results.

RESULTS

Seven prospective cohort studies including 645 AF patients were included. Within a follow-up duration of up to 18 months, 244 patients developed AF recurrence. Pooled results showed that baseline circulating Gal-3 levels were significantly higher in patients with AF recurrence compared to those without (standardized mean difference: 0.74; 95% confidence interval (CI): 0.21 - 1.27; p = 0.007; I = 89%). Moreover, higher baseline Gal-3 levels were independently associated with a significantly higher risk of AF recurrence after catheter ablation (risk ratio: 1.17 per unit of Gal-3; 95% CI: 1.01 - 1.35; p = 0.03; I = 40%), which was independent of age, gender, and left atrial dimension. Sensitivity analyses did not significantly affect the results. However, there was a significant publication bias for predicting efficacy of associating preprocedural Gal-3 levels with AF recurrence.

CONCLUSIONS

Higher preprocedural Gal-3 levels may be associated with increased risk of AF recurrence in patients undergoing catheter ablation.

摘要

背景

半乳糖凝集素-3(Gal-3)参与纤维化和心力衰竭。然而,评估 Gal-3 与导管消融后心房颤动(AF)复发之间关系的流行病学研究结果并不一致。我们进行了一项荟萃分析,以全面评估基线循环 Gal-3 水平与接受导管消融的患者 AF 复发之间的关系。

方法

通过系统地搜索 PubMed 和 Embase 数据库来确定相关研究。使用随机效应模型对结果进行综合。通过一次删除一项研究进行敏感性分析,以评估结果的稳健性。

结果

纳入了 7 项前瞻性队列研究,共包括 645 例 AF 患者。在长达 18 个月的随访期间,244 例患者发生了 AF 复发。汇总结果显示,与未发生 AF 复发的患者相比,复发患者的基线循环 Gal-3 水平显著升高(标准化均数差:0.74;95%置信区间(CI):0.21 - 1.27;p = 0.007;I = 89%)。此外,较高的基线 Gal-3 水平与导管消融后 AF 复发的风险显著增加独立相关(Gal-3 每增加一个单位,风险比:1.17;95%CI:1.01 - 1.35;p = 0.03;I = 40%),这与年龄、性别和左心房大小无关。敏感性分析并未显著影响结果。然而,预测术前 Gal-3 水平与 AF 复发之间关联的疗效存在显著的发表偏倚。

结论

较高的术前 Gal-3 水平可能与接受导管消融的患者 AF 复发风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b92/6739774/76f86c6b8ac7/CDTP2019-4148129.001.jpg

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