Increased plasma homocysteine predicts arrhythmia recurrence after minimally invasive epicardial ablation for nonvalvular atrial fibrillation
| Autor: | Flavio Fiore, Giuseppe M.C. Rosano, Khalil Fattouch, Mario Siro Brigiani, Roberta Spirito, Francesco Bartolomucci, Mario Gaudino, Giuseppe Speziale, Giuseppe Nasso, Raffaele Bonifazi, Carlo Gaudio, Vito Romano, Mauro Lamarra |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
AUC Time Factors Homocysteine medicine.medical_treatment Kaplan-Meier Estimate chemistry.chemical_compound Electrocardiography Recurrence Risk Factors Atrial Fibrillation ROC Prospective Studies receiver operating characteristic Area under the curve Atrial fibrillation Liter Middle Aged Ablation Up-Regulation Hcy Treatment Outcome Quartile Thoracotomy Area Under Curve cardiovascular system Cardiology Catheter Ablation Female Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine medicine.medical_specialty area under the curve Hyperhomocysteinemia AF atrial fibrillation ECG electrocardiogram homocysteine radiofrequency RF TIA transient ischemic attack Aged Biomarkers Electrocardiography Ambulatory Humans Logistic Models Multivariate Analysis Proportional Hazards Models ROC Curve Risk Assessment Surgery Internal medicine Ambulatory medicine cardiovascular diseases Receiver operating characteristic Proportional hazards model business.industry medicine.disease chemistry business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 146(4):848-853 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2012.07.099 |
| Popis: | ObjectiveMinimally invasive epicardial ablation via right minithoracotomy is an emerging option for patients with drug-refractory nonvalvular atrial fibrillation. To guide the development of rational treatment algorithms, factors predisposing to recurrence of arrhythmia need to be quantified and eventually treated. We addressed the association of the plasma levels of homocysteine and the recurrence of atrial fibrillation after minimally invasive ablation.MethodsWe obtained peripheral blood samples from 104 patients at follow-up after arrhythmia surgery; the homocysteine concentration was expressed as micromoles per liter. Prospective follow-up was conducted through electrocardiogram Holter monitoring (average 18.5 ± 5.8 months). Stratified analysis (high vs low homocysteine) was based on the cutoff value for the last quartile of homocysteine concentration (16 μmol/L). Time-to-event and diagnostic performance analyses were performed.ResultsThe rate of freedom from atrial fibrillation was 89.4% at the end of follow-up. Elevated circulating homocysteine level, persistent type of atrial fibrillation, and increased left atrial dimension independently predicted the recurrence of atrial fibrillation during the follow-up (adjusted Cox regression). Patients with a high homocysteine level were more likely to have atrial fibrillation recurrence (stratified Kaplan–Meier, P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|