title: Neopterin and interleukin-6 as predictors of recurrent atrial fibrillation.
abstract: OBJECTIVE
  Available evidence suggests that inflammation may be associated with atrial fibrillation (AF). This prospective and observational study aimed to assess whether plasma neopterin (NPT) and interleukin-6 (IL-6) levels before and after electrical cardioversion (CV) predict AF recurrence.
  
  
  METHODS
  The study was designed as a prospective observational trial. Blood samples were collected (24 hours before, 24 h after CV, and 7 days after CV) in 60 patients with a dual-chamber pacemakar and preserved left ventricular systolic function who underwent successful CV of persistent AF. All significant parameters associated with AF recurrence lasting ≥30 min and detected by pacemaker data logs were evaluated in multivariate logistic regression analysis. Echocardiography was performed 7 days after CV in patients with sinus rhythm. The control group included 17 subjects without AF.
  
  
  RESULTS
  The analysis included 51 patients who remained in sinus rhythm 7 days after CV. During 12 months of follow-up, AF recurred in 46 patients. Baseline IL-6 levels did not differ between the two groups, but baseline NPT levels were higher in the study group than in the control group (19±7 vs. 11±5 nmol/mL, p<0.001). NPT levels of ≥14.6 nmol/L at baseline and ≥13.3 nmol/L 7 days after CV separated the patients with AF recurrence from those without arrhythmia after CV. Only left atrial emptying fraction <38% was an independent predictor of AF recurrence (p=0.03), whereas NPT levels of ≥13.3 nmol/L 7 days after CV showed borderline statistical significance (p=0.07).
  
  
  CONCLUSIONS
  Increased NPT level was observed in patients with persistent AF. Neither baseline IL-6 and NPT levels nor their changes within 7 days after CV were predictive of AF recurrence. Further studies are needed to establish the prognostic significance of NPT in patients with AF.
authors.affiliation: Department of Cardiology and Electrotherapy Medical University of Gdansk, Gdansk-Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Lewicka
authors.affiliation: Department of Cardiology MSW Hospital in Gdansk, Gdansk-Poland.
authors.forename: Julita
authors.initials: J
authors.lastname: Dudzinska-Gehrmann
authors.affiliation: Department of Cardiology and Electrotherapy Medical University of Gdansk, Gdansk-Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Dabrowska-Kugacka
authors.affiliation: Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdansk-Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Zagozdzon
authors.affiliation: Department of Cardiology and Electrotherapy Medical University of Gdansk, Gdansk-Poland. ollizz@gumed.edu.pl.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Lizewska
authors.affiliation: Department of Cardiology and Electrotherapy Medical University of Gdansk, Gdansk-Poland.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Danilowicz-Szymanowicz
authors.affiliation: Department of Cardiology and Electrotherapy Medical University of Gdansk, Gdansk-Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Raczak