| BackgroundAtrial fibrillation(AF)is a common sustained cardiac arrhythmia clinically which is associated with a marked increasingly morbidity and mortality with the growth of the age.It has been shown that the complications of AF such as thromboembolism,heart failure,sudden cardiac death seriously affected the quality of life in patients and bring socioeconomic burden.In recent years,catheter ablation has been recognized as a first-line therapy in maintaining sinus rhythm for patients with symptomatic and drug-refractory paroxysmal atrial fibrillation(PAF),even persistent atrial fibrillation(PeAF)patients can also benefit from it.Even if undergoing the successful ablation,there have been up to 30%-50%of patients with AF suffering recurrence.As the main cause of atherosclerosis and cardiovascular disease,dyslipidemia is gradually recognized as a major risk factor for the occurrence and maintenance of atrial fibrillation.However,the relationship between dyslipidemia and atrial fibrillation has been controversial.The noval index of low-to high-density lipoprotein cholesterol(LDL-C/HDL-C)ratio was considered as a useful indicator of stratification in patients with coronary atherosclerotic heart disease(ASCVD),but few studies have explored the association between the ratio and atrial fibrillation.The aim of this study was to investigate the predictive value of LDL-C/HDL-C ratio for AF recurrence after radiofrequency catheter ablation.ObjectiveThe aim of this study was to investigate the predictive value of LDL-C/HDL-C ratio for AF recurrence after radiofrequency catheter ablation(RFCA)and indentify the independent risk factors for the recurrence of atrial fibrillation and provide a reference value for evaluating the risk of AF recurrence after catheter ablation.MethodFrom January 2016 to December 2017,208 AF patients who received first-time RFCA surgery were divided into relapse group with 45 cases and non-recurrent group with 163 cases based on follow-up result.Then the patients were divided into two groups according to a cut-off level of LDL-C/HDL-C ratio.We compared pre-ablative baseline characteristics between the two groups and use the COX proportional harzards regression to examine the risk factors in predicting AF recurrence.The Kaplan-Meier method was used to analyze the incidence of recurrence in patients with different LDL-C/HDL-C ratio levels.Result1 Compared with the non-recurrence group,there were more female patients and more patients with hypertension in the recurrence group.Furthermore,the CHA2DS2-VASc score,HAS-BLED score,left atrial diameter(LAD),LDL-C/HDL-C ratio were significantly increased in the recurrence group(P<0.05)2 Multivariate Cox proportional Hazard modelling results showed that LAD,the CHA2DS2-VASc score and the LDL-C/HDL-C ratio were independent predictors of AF recurrence after radiofrequency catheter ablation(HR:1.057,95%CI:1.003～1.113,P:0.037;HR:1.571,95%CI:1.177～2.097,P:0.002;HR:1.688,95%CI:1.218～2.339,P:0.002)3 Using a cut-off level of 3.33,the pre-ablation LDL-C/HDL-C ratio level predicted AF recurrence during follow up,and the AUC of LDL-C/HDL-C ratio was 0.606(95%CI:0.505-0.706,P=0.031)4 Comparing the two groups of patients with different LDL-C/HDL-C ratios,patients with LDL-C/HDL-C ratio>3.33 showed the increased BMI level,blood uric acid(SUA)and lymphocyte count(LYM)level(P<0.05)5 Kaplan-Meier curve analysis of the incidence of recurrence in patients with different LDL-C/HDL-C ratio levels showed that patients with LDL-C/HDL-C ratio level>3.33 had a significantly high risk of AF recurrence(P<0.001)Conclusion1 The LDL-C/HDL-C ratio was an independent predictor for AF recurrence after catheter ablation.Patients with a pre-ablation LDL-C/HDL-C ratio level>3.33 had a increased risk of developing AF recurrence after catheter ablation2 In addition to the LDL-C/HDL-C ratio,the left atrial diameter(LAD)and the CHA2DS2-VASc score were also independent predictors for AF recurrence after catheter ablation. |
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