title: Plasma homocysteine levels predict early recurrence after catheter ablation of persistent atrial fibrillation.
abstract: OBJECTIVE
  To assess the association and the predictive value of plasma homocysteine (Hcy) with early recurrence in persistent atrial fibrillation patients after a single ablation procedure.
  
  
  RESULTS
  Two hundred and fifty-seven consecutive patients with persistent atrial fibrillation who underwent successful catheter ablation were enrolled. Early recurrence of atrial tachyarrhythmia was documented within 3 months after ablation. The logistic regression analysis and Kaplan-Meier curve analysis were used to evaluate the association of Hcy with early recurrence. During the 3-month follow-up, 75 (29.2%) patients experienced recurrence. Patients with early recurrence were older, more likely to have larger left atrial diameter and higher CHA2DS2-VASc score (all P< 0.001). Plasma Hcy levels were significantly elevated in patients with early recurrence compared with those without early recurrence (15.1 ± 4.1 vs. 12.4 ± 3.7 µmol/L, P< 0.001). In multivariate analysis, Hcy was significantly associated with early recurrence (OR 1.188, 95% CI 1.097-1.286, P< 0.001). Hcy demonstrated a predictive value with AUC of 0.688 (95% CI 0.623-0.753, P< 0.001). The optimal cut-off value was 14 µmol/L for Hcy (sensitivity 69%, specificity 59%). Patients with Hcy ≥14 µmol/L had higher early recurrence rate compared with those with Hcy <14 µmol/L (41 vs. 22%, P= 0.006).
  
  
  CONCLUSIONS
  Plasma Hcy levels are associated with early recurrence of atrial tachyarrhythmia after catheter ablation in persistent atrial fibrillation patients, thus it should be taken into account in prediction of early recurrence.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Cardiology, Suizhou Hospital, Hubei University of Medicine, Hubei, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yao
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Zhen-Hua
authors.initials: ZH
authors.lastname: Lu
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Ri-Bo
authors.initials: RB
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: De-Yong
authors.initials: DY
authors.lastname: Long
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Chen-Xi
authors.initials: CX
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Cai-Hua
authors.initials: CH
authors.lastname: Sang
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Jian-Qiang
authors.initials: JQ
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Rong-Hui
authors.initials: RH
authors.lastname: Yu
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China chshma@vip.sina.com.
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006710:Homocysteine
keywords: Atrial fibrillation; Catheter ablation; Early recurrence; Homocysteine