Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec;15(12):725-731.
doi: 10.11909/j.issn.1671-5411.2018.12.008.

Value of cystatin C in predicting atrial fibrillation recurrence after radiofrequency catheter ablation

Li-Li Jin  1 , Ling You  1 , Rui-Qin Xie  1
Affiliations

Value of cystatin C in predicting atrial fibrillation recurrence after radiofrequency catheter ablation

Li-Li Jin et al. J Geriatr Cardiol. 2018 Dec.

Abstract

Backgroud: Recent studies have demonstrated that cystatin C is a valuable risk marker for cardiovascular disease morbidity and mortality. Therefore, we hypothesized that the pre-ablation cystatin C level was associated with post-ablation atrial fibrillation (AF) recurrence.

Methods: 207 patients were enrolled and completed in this prospective observational study. Patients with AF scheduled for receive radiofrequency catheter ablation (RFCA) therapy were screened for the study. Before ablation therapy, electrocardiogram, 24 h holter monitor, transesophageal echocardiography, serum cystatin C, high-sensitivity C-reactive protein, creatinine levels, and routine blood examinations were examined. After ablation, patients were followed up every week for the first month, and then at 2, 3, 6, 9, and 12 months. Thereafter, patients came back to out-patient clinic every six months regularly. Electrocardiogram or 24 h holter monitor were repeated if the patient experienced palpitations or every six months. AF recurrence was defined as atrial fibrillation/atrial flutter or atrial tachycardia lasting ≥ 30 seconds within three months after therapy.

Results: Compared to patients with no AF recurrence, patients with recurrence had longer AF history (P = 0.007), more early recurrence (P = 0.000), a larger left atrium (P = 0.004), and higher pre-ablation cystatin C levels (P = 0.000). Multivariate regression analysis revealed that cystatin C and left atria (LA) diameter were risk factors for AF recurrence. After adjusting for LA diameter, the risk of AF recurrence increased 30% with every milligram cystatin C elevation (95% CI: 1.117-1.523).

Conclusions: Pre-ablation cystatin C levels were associated with AF recurrence after RFCA therapy, an optimal cut-off value of 1.190 mg/L (sensitivity = 0.576; specificity = 0.851).

Keywords: Atrial fibrillation; Catheter ablation; Cystatin C; Recurrence.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. ROC curve of baseline level of cystatin C for predicting AF recurrence after RFCA.
The cur-off level is 1.190 mg/mL, the sensitivity is 0.576 and the specificity is 0.851. AF: atrial fibrillation; RFCA: radiofrequency catheter ablation; ROC: receiver operating characteristic.
Figure 2.
Figure 2.. Kaplan-Meier curve for freedom of AF recurrence based on the baseline levels of cystatin C.
AF: atrial fibrillation.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Schnabel RB, Yin X, Gona P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet. 2015;386:154–162. - PMC - PubMed
    1. Bordignon S, Chiara Corti M, Bilato C. Atrial fibrillation associated with heart failure, stroke and mortality. J Atr Fibrillation. 2012;5:467. - PMC - PubMed
    1. Kirchhof P, Ammentorp B, Darius H, et al. Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF) Europace. 2014;16:6–14. - PMC - PubMed
    1. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Rev Esp Cardiol (Engl Ed) 2017;70:50. - PubMed
    1. Kirchhof P, Calkins H. Catheter ablation in patients with persistent atrial fibrillation. Eur Heart J. 2017;38:20–26. - PMC - PubMed

LinkOut - more resources