The value of serum N-terminal pro-brain natriuretic peptide, cystatin C and interleukin-17 in predicting relapse after radiofrequency catheter ablation in elderly patients with persistent atrial fibrillation
10.3760/cma.j.cn115455-20230804-00077
- VernacularTitle:血清N末端脑钠肽前体、胱抑素C和白细胞介素-17对老年持续性心房颤动患者射频导管消融术后复发的预测价值
- Author:
Yue ZHANG
1
;
Min HUANG
;
Jianmei CHANG
Author Information
1. 上海市浦东新区人民医院心血管内科，上海 200120
- Keywords:
Atrial fibrillation;
Catheter ablation;
Natriuretic peptide, brain;
Cystatin C;
Interleukin-17
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(7):611-617
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of N-terminal pro-brain natriuretic peptide (NT-proBNP), cystatin C (CysC) and interleukin-17 (IL-17) in relapse after radiofrequency catheter ablation (RFCA) in elderly patients with persistent atrial fibrillation.Methods:The clinical data of 69 elderly patients with persistent atrial fibrillation underwent RFCA (atrial fibrillation group) in Shanghai Pudong New Area People′s Hospital from January 2020 to December 2021 were retrospectively analyzed. Additionally, 69 healthy subjects underwent physical examinations during the same period were selected as the healthy control group. The levels of serum NT-proBNP, CysC and IL-17 were detected. The relapse after RFCA was recorded. Multivariate Logistic regression was used to analyze the independent risk factors of relapse after RFCA in elderly patients with persistent atrial fibrillation. The values of NT-proBNP, CysC and IL-17 in predicting the relapse after RFCA in elderly patients with persistent atrial fibrillation were evaluated by the receiver operating characteristics (ROC) curve.Results:The serum NT-proBNP, CysC and IL-17 before operation and 7 d after operation in atrial fibrillation group were significantly higher than those in healthy control group: (789.41 ± 89.22) and (358.96 ± 50.24) ng/L vs. (114.38 ± 32.56) ng/L, (1.42 ± 0.30) and (1.20 ± 0.21) mg/L vs. (0.98 ± 0.17) mg/L, (12.48 ± 3.21) and (9.83 ± 2.58) ng/L vs. (7.85 ± 2.13) ng/L, and there were statistical differences ( P<0.05); compared with healthy control group, there were no statistical difference in the indexes 1 and 3 months after operation ( P>0.05). The serum NT-proBNP, CysC and IL-17 7 d, and 1, 3 month after operation in atrial fibrillation group were significantly lower than those before operation, and there were statistical differences ( P<0.05). The 69 patients were followed up for 1 year, with 20 cases experiencing relapse and 49 cases not experiencing relapse. There were no statistical differences in the serum NT-proBNP, CysC and IL-17 before operation and 7 d after operation between relapse patients and non-relapse patients ( P>0.05); the serum NT-proBNP, CysC and IL-17 1 and 3 months after operation in relapse patients were significantly higher than those in non-relapse patients, 1 month after opertion: (132.49 ± 32.84) ng/L vs. (115.56 ± 27.61) ng/L, (1.10 ± 0.15) mg/L vs. (0.99 ± 0.12) mg/L and (8.59 ± 1.76) ng/L vs. (7.65 ± 1.58) ng/L; 3 months after operation: (140.37 ± 32.83) ng/L vs. (119.90 ± 25.44) ng/L, (1.17 ± 0.20) mg/L vs. (1.02 ± 0.15) mg/L and (9.12 ± 2.31) ng/L vs. (7.74 ± 1.80) ng/L, and there were statistical differences ( P<0.05 or<0.01). Multivariate Logistic regression analysis result showed that the serum NT-proBNP, CysC and IL-17 1 and 3 months after operation were the independent risk factors of relapse after RFCA in elderly patients with persistent atrial fibrillation ( P<0.01). ROC curve analysis result showed that the area under curve (AUC) of the serum NT-proBNP, CysC, IL-17 and the combination of three indexes 3 months after operation in predicting the relapse after RFCA in elderly patients with persistent atrial fibrillation were higher than those at 1 month after operation (0.813 vs. 0.783, 0.770 vs. 0.721, 0.725 vs. 0.717 and 0.927 vs. 0.833; P<0.05), the AUC of combination of three indexes 1 and 3 months after operation was significantly higher than that of individual indexes at each time point ( P<0.05). Conclusions:The elevated levels of serum NT-proBNP, CysC and IL-17 after operation in elderly patients with persistent atrial fibrillation are closely related to the relapse after RFCA, and can be used as biochemical indicators to predict recurrence.
