Abstract
BackgroundThe monocyte/high-density lipoprotein ratio (MHR) has emerged as a promising alternative biomarker in the fields of cardiovascular disease and atrial fibrillation (AF). This retrospective study was aimed to explore the predictive value of the MHR for the late recurrence of AF after radiofrequency ablation.MethodsFrom April 2015 to October 2018, patients with paroxysmal AF who had undergone radiofrequency catheter ablation at Subei People’s Hospital of Jiangsu Province were enrolled in our study. All the participants were observed until November 2019 after the procedure. During the postoperative follow up, the patients were categorized into the recurrence group and maintenance of sinus rhythm group based on who had experienced AF recurrence.ResultsOne hundred twenty-five patients were diagnosed with paroxysmal AF, with an average age of 61.2 ± 9.3 years. Forty-seven patients had developed late recurrence during a mean follow up of 25.1 ± 12.0 months. The AF recurrence event rates were significantly increased in the highest MHR tertile compared with those in the lowest MHR tertile (22.0% vs. 57.1%; P < 0.05). On multivariate logistic regression analysis, the preablation MHR (OR = 1.34; 95% CI = 1.12 ~ 1.60; P = 0.001) and left atrial diameter (LAD) (OR = 1.21, 95% CI = 1.08 ~ 1.35; P = 0.001) were independent risk factors predicting the recurrence of AF after radiofrequency ablation. Furthermore, receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of the MHR was 0.712 (95% CI = 0.618 ~ 0.806; P = 0.000) and that of LAD was 0.739 (95% CI = 0.653 ~ 0.814; P = 0.000). Z-test found no significant difference between the MHR and LAD regarding the AUC (Z = 0.451; P = 0.652).ConclusionAn elevated preablation MHR was associated with an increased risk of the postoperative recurrence of AF. Additionally, the MHR independently predicted the late recurrence of paroxysmal AF after radiofrequency ablation, with the same predictive value as LAD.
Highlights
The monocyte/high-density lipoprotein ratio (MHR) has emerged as a promising alternative biomarker in the fields of cardiovascular disease and atrial fibrillation (AF)
The two groups were significantly different in terms of the AF duration, history of diabetes mellitus, body mass index, D-dimer level, monocyte count, HDL cholesterol level, monocyte/HDL ratio, and left atrial diameter (LAD) (P < 0.05)
The patients were stratified into 3 groups according to the MHR tertile (T1: < 5.68; T2: 5.68–8.29; T3:≥8.29) and subgroup analysis showed that patients in T3 had a higher rate of AF recurrence than those in T1
Summary
The monocyte/high-density lipoprotein ratio (MHR) has emerged as a promising alternative biomarker in the fields of cardiovascular disease and atrial fibrillation (AF). This retrospective study was aimed to explore the predictive value of the MHR for the late recurrence of AF after radiofrequency ablation. Patients with AF are more likely to have a high incidence of stroke and systemic embolism, seriously affecting the quality of life of patients and resulting in a huge burden to public health [1]. Pulmonary vein electrical isolation achieved by radiofrequency catheter ablation has been the cornerstone of catheter-based therapies for AF, with the greatest efficacy as a promising treatment option in patients with paroxysmal AF [2]. It is of great significance to detect the clinical factors influencing the successful maintenance of the sinus rhythm in patients with AF after ablation
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