Serum uric acid levels correlate with recurrence of paroxysmal atrial fibrillation after catheter ablation
Serum uric acid levels correlate with recurrence of paroxysmal atrial fibrillation after catheter ablation
复制标题
血清尿酸水平与导管消融后阵发性心房颤动的复发相关
DOI：
10.3760/cma.j.issn.0366-6999.20122154
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发表时间：
2013-03-05
影响因子：
6.1
通讯作者：
Ma Chang-sheng
中科院分区：
文献类型：
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作者：
He Xiao-nan;Li Song-nan;Ma Chang-sheng
背景近年来，血尿酸（SUA）在心房颤动（AF）中的作用引起了广泛关注。本研究的目的是建立是否有SUA和复发的阵发性AF导管ablation.Methods 330例诊断为阵发性AF的患者之间的关系进行了分析。根据术前SUA测量结果和随访结果将患者分为四分位数，采用Kaplan-Meier估计结合Log-rank检验分析SUA对房颤复发的影响。采用多因素Logistic分析术前临床变量与消融术后临床结局的相关性。结果随访3.0-16.3个月，平均随访时间（9.341 ± 3.667）个月，术后复发率从最低SUA四分位数到最高SUA四分位数分别为16.0%、26.4%、28.3%和29.3%（P=0.014）。校正性别、体重指数（BMI）、高血压、血清高敏C反应蛋白（hsCRP）、甘油三酯（TG）、左心房直径（LA）、估计肾小球滤过率（eGFR）和SUA后，SUA最高四分位数受试者的复发风险高于最低四分位数受试者（风险比2.804，95%置信区间1.466-5.362，P=0.002）。多因素Logistic回归分析显示，SUA是房颤复发的独立预测因子（危险比1.613，95%可信区间1.601-1.625，P=0.014）。
Background Recently there has been a great deal of interest in the role of serum uric acid (SUA) in atrial fibrillation (AF). The objective of this study was to establish whether there is a relationship between levels of SUA and recurrence of paroxysmal AF after catheter ablation.Methods Three hundred and thirty patients diagnosed with paroxysmal AF were analyzed. Patients were categorized into quartiles on the basis of their pre-operative SUA measurement and follow-up, and Kaplan-Meier estimation with a Log-rank test was used for the analysis of the influence of SUA on the recurrence of AF. Pre-procedural clinical variables were correlated with the clinical outcome after ablation using multivariate Logistic analysis. A Cox proportional hazards model was used to estimate the relationship between SUA and the recurrence of AF.Results After a mean follow-up of (9.341 +/- 3.667) (range 3.0-16.3) months, recurrence rates from the lowest SUA quartile to the highest SUA quartile were 16.0%, 26.4%, 28.3%, and 29.3% respectively (P=0.014). After adjustment for gender, body mass index (BMI), hypertension, serum levels of high sensitivity C-reactive protein (hsCRP), triglyceride (TG), left atrial diameter (LA), estimated glomerular filtration rate (eGFR), and SUA, there was an increased risk of recurrence in subjects in the highest SUA quartile compared with those in the lowest quartile (hazard ratio 2.804, 95% confidence interval 1.466-5.362, P=0.002). Following multivariate Logistical analysis, SUA was found to be an independent predictor of recurrence (hazard ratio 1.613, 95% confidence interval 1.601-1.625, P=0.014).Conclusion In a retrospective study of patients with paroxysmal AF undergoing catheter ablation, elevated preoperative SUA levels were associated with a higher rate of recurrence of AF.