血浆碳水化合物抗原 125 预测射频导管消融术后心房颤动复发。
Plasma carbohydrate antigen-125 for prediction of atrial fibrillation recurrence after radiofrequency catheter ablation.
机构信息
Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
Department of Physical Medicine and Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
出版信息
BMC Cardiovasc Disord. 2021 Aug 19;21(1):400. doi: 10.1186/s12872-021-02207-y.
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
Elevated preoperative CA-125 levels are related to a higher risk of AF recurrence and can independently predict AF recurrence following RFCA.
背景
升高的血浆糖链抗原 125（CA-125）水平与新发心房颤动（AF）和心力衰竭密切相关，但 CA-125 水平与射频导管消融（RFCA）后 AF 复发之间的关系仍未得到充分研究。我们旨在评估升高的 CA-125 水平是否与 RFCA 后 AF 的长期复发有关。
方法
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 AF 复发的预测因素。
结果
在 353 名入选患者中，85 名患者（24.1%）在 12 个月的随访中出现 AF 复发。与无 AF 复发的患者相比，这些患者的基线 CA-125 水平明显更高[(18.71±12.63) vs. (11.27±5.40) U/mL，P<0.001]。CA-125 四分位 1-4 组的 AF 复发发生率分别为 11.5%、13.3%、21.6%和 50.0%（P 趋势<0.001）。CA-125 四分位 1-4 组的 AF 复发调整后的危险比（aHR）分别为 1.00（参考）、1.085（95%CI，0.468-2.520）、1.866（95%CI，0.867-4.019）和 4.246（95%CI，2.113-8.533）（P 趋势<0.001）。当将 CA-125 作为连续数据进行研究时，也得到了类似的效果（CA-125 每单位增加的 aHR，3.225，95%CI，2.258-4.606；P<0.001）。当确定 CA-125 的预设截断值为 13.75 U/mL 时，CA-125≥13.75 U/mL 的患者比 CA-125<13.75 U/mL 的患者发生 AF 复发的风险更高（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。
结论
术前升高的 CA-125 水平与 AF 复发风险增加相关，并可独立预测 RFCA 后 AF 的复发。
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