Utility of Soluble ST2 biomarker to predict recurrence after electrical cardioversion in patients with atrial fibrillation

Abstract

Abstract Background Atrial fibrillation (AF) is the more frequent arrhythmia in clinical practice. The ST2S is a biomarker that has demonstrated to be predictor of cardiovascular outcomes in patients with heart failure but there is scarce information of his utility in patients with AF. Purpose Considering the characteristics of the ST2S we hypothesize this biomarker could correlate to recurrence in patients with AF and electrical cardioversion (ECV). Methods This was an observational and prospective clinical trial. We compared all patients with AF referred for ECV with a control group without AF, from September 1th 2016 to September 30 2019. Clinical, ECG, echocardiographic and ST2S levels were analyzed in both groups at basal, at 3 and 6 months of follow-up in such cases with AF. Patients with inflammatory or allergic diseases, moderate/severe ventricular dysfunction, structural cardiomyopathy, moderate/severe hepatic, renal or respiratory disease were excluded. Results We included a total of 94 patients with AF and 40 paired controls. Clinical variables are presented in Table 1. Fifty-eight (61.7%) patients with AF had recurrence at follow-up. There was a significant difference between the ST2S levels at baseline between AF patients (17163.8 pg/mL) and controls (11016.2 pg/mL) (p=0.001). ST2S biomarker levels at 3 and 6 months of follow-up decreased in those patients without AF recurrence as shown in Figure 1. Covariable models were performed and ST2S biomarker levels at 3 months were significant to predict recurrence at 6 months follow-up (Table 2). The calculated cut-point of the biomarker was of 15511.51 pg/ml with a c-value: 0.669. Conclusions In our experience ST2S was a useful biomarker to predict recurrence of AF after ECV. Considering the size of the study more studies should be performed to confirm this results. Funding Acknowledgement Type of funding sources: None.