High Homocysteine Levels Predict the Recurrence of Atrial Fibrillation After Successful Electrical Cardioversion
High Homocysteine Levels Predict the Recurrence of Atrial Fibrillation After Successful Electrical Cardioversion
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DOI：
10.1536/ihj.51.30
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发表时间：
2010-01-01
影响因子：
1.5
通讯作者：
Sabovic, Miso
中科院分区：
文献类型：
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作者：
Naji, Franjo;Suran, David;Sabovic, Miso
最近的数据表明，血浆同型半胱氨酸水平升高可能与房颤(AF)有关。本研究的目的是探讨血浆同型半胱氨酸水平升高是否可以预测成功电复律后房颤的复发率。83例持续性房颤持续至少7天的患者(63+/-12年，61.4%的男性)在成功的电复律后被纳入研究。在复律前进行超声心动图和血浆同型半胱氨酸测定，并获得患者的基线特征。对患者进行为期18个月的监测。根据血浆同型半胱氨酸浓度最后四分位数的截断值(>；14.4mU/L)将患者分为两组。Kaplan Meier分析显示18个月后两组房颤复发率差异有统计学意义(P=0.02，LOG检验)。COX比例风险多因素分析显示，房颤复发的预测因素为房颤持续时间(OR 1.05，95%CI 1.02~1.08，P=0.00)、胺碘酮治疗(OR 0.39，95%CI 0.21~0.72，P=0.00)和同型半胱氨酸水平
Recent data suggest that elevated plasma levels of homocysteine could be associated with atrial fibrillation (AF). The aim of our study was to investigate whether elevated plasma Hcy levels were predictive of the recurrence rate of AF after successful electrical cardioversion.Eighty-three patients (63 +/- 12 years, 61.4% men) with persistent AF lasting at least 7 days were included after successful electrical cardioversion. Echocardiography and plasma homocysteine assay were performed prior to cardioversion and patient baseline characteristics were obtained. Patients were monitored for a period of 18 months.The patients were divided into two groups using a cut-off value for the last quartile of plasma homocysteine concentration (> 14.4 mu mol/L). Kaplan Meier analysis showed a statistically significant difference in AF recurrence rates between both groups after 18 months (P = 0.02, log rank test). Cox proportional hazards multivariate analysis showed that predictors of AF recurrence were the duration of AF (OR 1.05, 95% CI 1.02-1.08, P = 0.00), treatment with amiodarone (OR 0.39, 95% CI 0.21-0.72, P = 0.00), and homocysteine level