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; I2 = 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; I2 = 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.
Highlights
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and the incidence of atrial fibrillation (AF) increases with aging [1]
The pooled results were insignificant after including these two hypothetical studies (RR: 1.10 per unit of Gal-3; 95% confidence interval (CI): 0.95 to 1.28; p = 0.19; Figure 4). These results suggest that the association between baseline Gal-3 levels and the risk of AF recurrence may be affected by publication bias. In this meta-analysis we pooled the results of all available prospective cohort studies and found that baseline circulating Gal-3 levels are significantly higher in patients with AF recurrence compared to those without after catheter ablation
Preprocedural circulating Gal-3 levels are independently associated with a higher risk of AF recurrence after catheter ablation
Summary
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and the incidence of AF increases with aging [1]. It has been suggested that many patients do not develop AF recurrence even after reconnection of the pulmonary veins [6] These results suggested that the potential mechanisms underlying AF recurrence after catheter ablation are complex. Epidemiological studies evaluating the association between Gal-3 and atrial fibrillation (AF) recurrence after catheter ablation showed inconsistent results. We conducted a metaanalysis to comprehensively evaluate the relationship between baseline circulating Gal-3 levels and AF recurrence in patients undergoing catheter ablation. 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; I2 = 89%). Higher preprocedural Gal-3 levels may be associated with increased risk of AF recurrence in patients undergoing catheter ablation
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