title: High plasma level of soluble RAGE is independently associated with a low recurrence of atrial fibrillation after catheter ablation in diabetic patient.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is closely associated with metabolic syndrome, and the receptor for advanced glycation end products (RAGE) pathway is involved in insulin resistance and cardiac remodelling. We hypothesized that plasma level of soluble RAGE (sRAGE) would predict clinical outcome after radiofrequency catheter ablation for AF.
  
  
  RESULTS
  We measured pre-procedural plasma level of sRAGE in 496 patients who underwent AF ablation (142 patients with diabetes, 354 patients without diabetes selected by matching them with diabetic patients according to age, sex, and AF type). (i) Plasma level of sRAGE was significantly higher in diabetic patients than in non-diabetics (580.0 ± 576.4 vs. 435.8 ± 280.7 pg/mL, P = 0.005), but there was no difference in sRAGE levels between patients with clinical recurrence of AF and those without. (ii) During 24.5 ± 18.0 months of follow-up, the recurrence of AF was significantly lower in the diabetic patient group with high sRAGE (≥418 pg/mL based on the median value) than the diabetic patient group with low sRAGE (log-rank P = 0.045). This was especially pronounced in patients with paroxysmal AF and diabetes (log-rank P = 0.016), but no association was found in non-diabetics. (iii) In multivariate Cox regression analysis, high sRAGE (HR 0.395, 95% CI 0.175-0.894, P = 0.026) and paroxysmal AF (HR 0.387, 95% CI 0.179-0.835, P = 0.016) were independently associated with the favourable clinical outcome of rhythm control after AF ablation in diabetic patients.
  
  
  CONCLUSIONS
  High plasma level of sRAGE was independently associated with low AF recurrence after catheter ablation in diabetic patients, especially those with paroxysmal AF.
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Pil-Sung
authors.initials: PS
authors.lastname: Yang
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea hnpak@yuhs.ac.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D048909:Diabetes Complications; D004594:Electrophysiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D016016:Proportional Hazards Models; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood*; D012008:Recurrence; D056910:Republic of Korea; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: C000593871:AGER protein, human; D000067759:Receptor for Advanced Glycation End Products
keywords: Atrial fibrillation; Catheter ablation; Diabetes mellitus; Inflammation; Oxidative stress; Recurrence; Soluble RAGE