Relationship between plasma cancer antigen (CA)-125 level and one-year recurrence of atrial fibrillation after catheter ablation
Relationship between plasma cancer antigen (CA)-125 level and one-year recurrence of atrial fibrillation after catheter ablation
复制标题
血浆癌抗原（CA）-125水平与导管消融术后房颤一年复发的关系
DOI：
10.1016/j.cca.2019.11.001
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发表时间：
2020-03-01
影响因子：
5
通讯作者：
Hu, Xiaokang
中科院分区：
文献类型：
--
作者：
Huang, Zhouqing;Liang, Xiaohe;Hu, Xiaokang
背景：既往研究表明血浆癌抗原125（CA-125）与心力衰竭和新发心房颤动（AF）密切相关，但尚无研究报道CA-125浓度与AF消融晚期复发之间的关系。这项研究首次将CA-125描述为房颤消融后复发的生物标志物。方法：本研究共纳入了422名接受导管消融的房颤患者。结果：1年随访期间，326例患者（77.25%）维持窦性心律，83例患者（20.44%）出现房颤复发。 AF 复发患者的基线 CA-125 浓度高于维持窦性心律的患者 (P = 0.0001)。多变量 Cox 比例风险回归分析显示，持续性 AF（HR 2.212；95% CI：1.396-3.504，P = 0.001）和 CA-125 浓度（HR，1.003；95% (CI)：1.000-1.005，P = 0.019）是 AF 复发的独立预测因子。根据受试者工作特征（ROC）分析，CA-125的最佳截止值为11.05 U/ml，其敏感性和特异性分别达到65.6%和85.0%。此外，曲线下面积（AUC）值跨越80.3%（95% CI：0.750-0.857，P < 0.0001）。此外，亚组分析结果表明，持续性房颤患者的CA-125浓度较高，房颤复发的风险增加。结论：高CA-125浓度是房颤消融1年后房颤复发的独立预测因子，尤其是持续性房颤患者。
Background: Previous studies have shown that plasma cancer antigen-125 (CA-125) is closely related to heart failure and new-onset atrial fibrillation (AF), but no study reported the relationship between CA-125 concentrations and advanced recurrence of AF ablation. This research is the first to describe CA-125 as a biomarker for the recurrence of AF after ablation.Methods: A total of 422 AF patients undergoing catheter ablation were included in this study. Results: During the 1-y follow-up, 326 patients (77.25%) maintained a sinus rhythm, whereas 83 patients (20.44%) presented AF recurrence. The patients with AF recurrence showed higher CA-125 concentrations at baseline than those with maintained sinus rhythm (P = 0.0001). Multivariate Cox proportional hazards regression analyses revealed that persistent AF (HR 2.212; 95% CI: 1.396-3.504, P = 0.001) and CA-125 concentration (HR, 1.003; 95% (CI): 1.000-1.005, P = 0.019) were independent predictors of AF recurrence. According to the receiver operating characteristic (ROC) analysis, CA-125 yielded an optimal cut-off value of 11.05 U/ml, and its sensitivity and specificity reached 65.6% and 85.0%, respectively. In addition, the area under the curve (AUC) value spanned 80.3% (95% CI: 0.750-0.857, P < 0.0001). Moreover, the results of the subgroup analysis indicated that patients with persistent atrial fibrillation have higher concentrations of CA-125 and have an increased risk of the recurrence of AF.Conclusions: High CA-125 concentration is an independent predictor of AF recurrence after 1 y of AF ablation, especially in patients with persistent AF.