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血清尿酸与肌酐比值(UCR)与导管消融后心房颤动的复发有关。

Serum uric acid: creatinine ratio (UCR) is associated with recurrence of atrial fibrillation after catheter ablation.

机构信息

Department of Cardiology, Shandong First Medical University, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China.

Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Cheeloo College of Medicine, Shandong University, Jinan, China.

出版信息

Front Endocrinol (Lausanne). 2023 May 19;14:1110102. doi: 10.3389/fendo.2023.1110102. eCollection 2023.

Abstract

BACKGROUND AND AIMS

Studies showed that elevated preoperative serum uric acid(SUA) levels are associated with recurrence of atrial fibrillation(AF) after catheter ablation. UA:creatinine ratio(UCR - UA normalised for renal function) has appeared as a new biomarker and is considered to reflect endogenous UA levels preferably because it eliminates the influence of renal function. This study aimed to investigate the correlation between UCR and recurrence of AF after catheter ablation.

METHODS AND RESULTS

A total of 233 consecutive patients with symptomatic, drug-refractory AF underwent catheter ablation. All participants underwent history-taking, physical examination and blood biochemistry analysis at baseline. After a mean follow-up of 23.99 ± 0.76 months, recurrence ratios for each UCR quartile (from lowest quartile to highest) were 10.9%, 23.6%, 23.6%, and 41.8%, respectively (P = 0.005). Multivariate Cox regression analysis revealed that UCR was an independent predictor of AF recurrence (HR 1.217, 95%CI 1.008-1.468; P = 0.041). Subgroup analysis showed that UCR was associated with AF recurrence in paroxysmal AF (HR 1.426, 95% CI 1.092-1.8608; P = 0.009) and in male patients (HR 1.407, 95% CI 1.015-1.950; P = 0.04). A cut-off point of 4.475 for the UCR had sensitivity of 65.5% and specificity of 59.6% in predicting AF recurrence (P = 0.001).

CONCLUSION

Our results demonstrate that elevated preoperative UCR is associated with recurrence of AF after catheter ablation, and it indicate UCR maybe a predictive factor for the recurrence of AF.

摘要

背景和目的

研究表明,术前血清尿酸(SUA)水平升高与导管消融后心房颤动(AF)复发有关。UA:肌酐比值(UA 经肾功能校正后的 UCR)作为一种新的生物标志物出现,被认为能更好地反映内源性 UA 水平,因为它消除了肾功能的影响。本研究旨在探讨 UCR 与导管消融后 AF 复发的相关性。

方法和结果

共 233 例有症状、药物难治性 AF 的连续患者接受了导管消融。所有参与者在基线时进行了病史询问、体格检查和血液生化分析。在平均 23.99±0.76 个月的随访后,每个 UCR 四分位(从最低四分位到最高四分位)的复发率分别为 10.9%、23.6%、23.6%和 41.8%(P=0.005)。多变量 Cox 回归分析显示,UCR 是 AF 复发的独立预测因素(HR 1.217,95%CI 1.008-1.468;P=0.041)。亚组分析显示,UCR 与阵发性 AF(HR 1.426,95%CI 1.092-1.8608;P=0.009)和男性患者(HR 1.407,95%CI 1.015-1.950;P=0.04)的 AF 复发相关。UCR 的截断值为 4.475 时,预测 AF 复发的敏感性为 65.5%,特异性为 59.6%(P=0.001)。

结论

我们的研究结果表明,术前 UCR 升高与导管消融后 AF 复发有关,提示 UCR 可能是 AF 复发的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e53/10235638/c4102217ba3f/fendo-14-1110102-g001.jpg

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