Department of Cardiovascular Medicine Kagawa Prefectural Central Hospital Takamatsu Kagawa Japan.
Department of Data Science/Clinical Epidemiology Hyogo Medical University Nishinomiya Hyogo Japan.
J Am Heart Assoc. 2024 Jun 18;13(12):e033969. doi: 10.1161/JAHA.123.033969. Epub 2024 Jun 15.
A lower serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio (EPA/AA) level correlates with cardiovascular events. Nevertheless, elevated serum EPA levels increase the risk of new-onset atrial fibrillation (AF) in older patients. The relationship between the EPA/AA and outcomes post-AF ablation remains unclear. This study investigated the impact of the EPA/AA on AF recurrence and cardiovascular events after AF ablation in older patients.
This retrospective cohort study examined consecutive patients with AF aged ≥65 years who underwent a first-time AF ablation. We compared the 3-year AF recurrence and 5-year major adverse cardiovascular event (MACE) rates between patients divided into high and low EPA/AA levels defined as above and below the median EPA/AA value before ablation. MACE was defined as heart failure hospitalizations, strokes, coronary artery disease, major bleeding, and cardiovascular death. Among the 673 included patients, the median EPA/AA value was 0.35. Compared with the low EPA/AA group, the high EPA/AA group had a significantly higher cumulative incidence of AF recurrence (39.3% versus 27.6%; log-rank =0.004) and lower cumulative incidence of MACE (13.8% versus 25.5%, log-rank =0.021). A high EPA/AA level was determined as an independent predictor of AF recurrence (hazard ratio [HR], 1.75 95% CI, 1.24-2.49; =0.002) and MACE (HR, 0.60 [95% CI, 0.36-0.99]; =0.046).
The EPA/AA was associated with AF recurrence and MACE after ablation in patients with AF aged ≥65 years.
血清二十碳五烯酸（EPA）与花生四烯酸（AA）比值（EPA/AA）水平降低与心血管事件相关。然而，血清 EPA 水平升高会增加老年患者新发心房颤动（AF）的风险。AF 消融后 EPA/AA 与结局之间的关系尚不清楚。本研究旨在探讨 EPA/AA 对老年 AF 患者 AF 消融后 AF 复发和心血管事件的影响。
本回顾性队列研究纳入了首次接受 AF 消融的年龄≥65 岁的 AF 患者。我们比较了根据消融前 EPA/AA 值中位数将患者分为高和低 EPA/AA 水平（定义为高于和低于中位数）组后 3 年 AF 复发率和 5 年主要不良心血管事件（MACE）发生率。MACE 定义为心力衰竭住院、卒中和冠心病、主要出血和心血管死亡。在纳入的 673 例患者中，EPA/AA 值中位数为 0.35。与低 EPA/AA 组相比，高 EPA/AA 组 AF 复发的累积发生率显著更高（39.3%比 27.6%；log-rank =0.004），MACE 的累积发生率显著更低（13.8%比 25.5%，log-rank =0.021）。高 EPA/AA 水平是 AF 复发（风险比[HR]，1.75；95%CI，1.24-2.49；=0.002）和 MACE（HR，0.60；95%CI，0.36-0.99；=0.046）的独立预测因素。
对于年龄≥65 岁的 AF 患者，EPA/AA 与 AF 消融后 AF 复发和 MACE 相关。
Zotero 插件
