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尿酸/高密度脂蛋白胆固醇比值与房颤射频消融术后复发的相关性OA北大核心CSTPCD

Correlation of uric acid to HDL-C ratio with recurrence after radiofrequency ablation of atrial fibrillation

中文摘要英文摘要

目的 探讨尿酸/高密度脂蛋白胆固醇比值(UHR)与非瓣膜性房颤患者射频消融术后晚期复发的相关性.方法 选取2018年1月-2022年1月首次接受经导管心脏射频消融治疗的586例非瓣膜性房颤患者的临床资料,根据UHR值三分位法,把研究人群分为低值组(n=196)、中值组(n=195)和高值组(n=195),房颤晚期复发为随访终点事件.比较三组间一般资料和实验室检查指标,采用Kaplan-Meier法估计并绘制生存曲线,采用多因素COX回归分析评价UHR与消融术后房颤复发的独立相关性并进行亚组分析.结果 随访时间内共记录了 182例(31.1%)房颤患者的晚期复发.Kaplan-Meier生存曲线显示UHR低值组、中值组、高值组三组间窦性心律维持率逐渐降低(Log-rank检验,P<0.001).在完全校正模型中,与低值组的患者比较,中值组和高值组消融术后房颤晚期复发的HR(95%CI,P)分别为 1.56(0.99~2.42,P=0.057)和 2.03(1.28~3.23,P=0.003).亚组分析显示,在年龄≥60岁、体质量指数≥25 kg/m2、持续性房颤、左心房内径≥4.3 cm、高血压病、无心力衰竭及无高脂血症的患者中,观察到UHR与消融术后房颤晚期复发的相关性显著.结论 非瓣膜性房颤患者较高的UHR值与射频消融术后房颤晚期复发风险增加独立相关.

Objective To investigate the correlation between uric acid to high-density lipoprotein cholesterol ratio(UHR)and late recurrence after radiofrequency ablation in patients with non-valvular atrial fibrillation(AF).Methods The clinical data of 586 patients with non-valvular AF underwent catheter radiofrequency ablation for the first time from January 2018 to January 2022 were selected,and the study population was classified into a low-value group(n=196),a medium-value group(n=195),and a high-value group(n=195)according to the trichoto-mous method based on the UHR value,with late recurrence of AF as the endpoint event of the follow up.The gener-al data and laboratory indexes were compared among the three groups.Survival curves were estimated and plotted u-sing the Kaplan-Meier method.Multivariate COX regression analysis was used to evaluate the independent correla-tion between UHR and recurrence of AF after ablation,followed by subgroup analysis.Results Late recurrence of AF was documented in a total of 182(31.1%)patients during the follow-up time.The Kaplan-Meier survival curve showed a gradual decrease in the maintenance rate of sinus rhythm across the UHR low-value group,middle-value group,and high-value group(Log-rank test,P<0.001).In the fully-adjusted model,compared with the patients in the low-value group,the medium-value and high-value groups had a post-ablation late recurrence of AF with HR(95%CI,P)were 1.56(0.99-2.42,P=0.057)and 2.03(1.28-3.23,P=0.003),respectively.Subgroup a-nalysis showed that the association between UHR and late recurrence of AF after ablation was remarkable among pa-tients with aged≥60 years,BMI≥25 kg/m2,persistent AF,LAD≥4.3 cm,hypertension,without heart failure and without hyperlipidemia.Conclusion Higher UHR values in patients with non-valvular AF are independently asso-ciated with an increased risk of late recurrence of AF after radiofrequency ablation procedures.

王保龙;王昌会

安徽医科大学第一附属医院心血管内科,合肥 230022

临床医学

尿酸高密度脂蛋白胆固醇心房颤动射频消融术晚期复发

uric acidhigh-density lipoprotein cholesterolatrial fibrillationradiofrequency ablationlate recur-rence

《安徽医科大学学报》 2024 (007)

1269-1274 / 6

国家自然科学基金区域联合基金重点项目(编号:U22A20154);安徽省高等学校自然科学研究项目(编号:2023AH053295)

10.19405/j.cnki.issn1000-1492.2024.07.025

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