title: Matrix Metalloproteinase Neutrophil Gelatinase-Associated Lipocalin Complex Predicts Atrial Fibrillation Recurrence after Electrical Cardioversion in Obese Patients.
abstract: BACKGROUND
  There is not much data on matrix metalloproteinase neutrophil gelatinase-associated lipocalin (MMP-NGAL) complex in patients with atrial fibrillation (AF).
  
  
  OBJECTIVE
  The aim of the study was to assess the value of MMP-NGAL complex in predicting AF recurrence after electrical cardioversion.
  
  
  METHODS
  The serum levels of NGAL, cystatin C, interleukin-6, high-sensitivity C-reactive protein, copeptin, MMP-NGAL complex, matrix metalloproteinase 2, tissue inhibitor of metalloproteinase 1, Von Willebrand factor, B-type natriuretic peptide and the urinary level of NGAL were evaluated before cardioversion.
  
  
  RESULTS
  A total of 83 patients with persistent AF were enrolled in the study. Left atrial diameter (LA) ≥4.5 cm was significantly associated with AF recurrence at follow-up (p = 0.009). In selected 39 obese patients, MMP-NGAL complex was associated with AF recurrence (p = 0.03). If the concentration of MMP-NGAL complex increased by 1 ng/ml, the odds of AF recurrence increased by 4% (OR 1.04; CI: 1.00-1.08; p = 0.03). MMP-NGAL complex did not correlate with AF recurrence in patients with a first episode of AF, in patients ≥65 years of age and in patients with a LA ≥4.5 cm or with chronic kidney disease.
  
  
  CONCLUSIONS
  It is known that the greater the BMI at baseline, the higher the likelihood of progression from paroxysmal to permanent AF. However, European Society of Cardiology (ESC) guidelines do not consider obese patients a population with a low likelihood of success of cardioversion. That is why we need a sensitive marker to predict sinus rhythm maintenance in such a population. We found that MMP-NGAL complex may predict AF recurrence after successful cardioversion in obese patients.
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Mlodawska
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Tomaszuk-Kazberuk
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Lopatowska
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Waszkiewicz
authors.affiliation: Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland; Department of Clinical Medicine, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Bachorzewska-Gajewska
authors.affiliation: Department of Nephrology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Malyszko
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Michniewicz
authors.affiliation: Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Dobrzycki
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Wlodzimierz Jerzy
authors.initials: WJ
authors.lastname: Musial
keywords: Atrial fibrillation; Cardioversion; Kidney function; MMP-NGAL; Obesity