Predictive value of serum FGF-23 in recurrence of patients with atrial fibrillation after radiofrequency ablation

doi:10.11958/20220317

Abstract

Abstract:

Objective To explore the predictive value of fibroblast growth factor-23 (FGF-23) in recurrence of patients with atrial fibrillation (AF) after radiofrequency ablation. Methods A total of 132 AF patients who received radiofrequency ablation were selected. According to the recurrence 12 months after radiofrequency ablation, patients were divided into the recurrence group (41 cases) and the non-recurrence group (91 cases). In addition, according to the expression level of serum FGF-23, patients were divided into the FGF-23 high expression group (56 cases) and the FGF-23 low expression group (76 cases). The parameters such as left atrial diameter (LAD) were detected by color Doppler ultrasound diagnostic instrument, and the serum level of FGF-23 was detected by enzyme-linked immunosorbent assay kit. Results Compared with the non-recurrent group, the proportion of persistent AF, LAD and serum FGF-23 levels were higher in the recurrence group (P<0.05). Persistent AF, excessive LAD and high serum FGF-23 level were risk factors for recurrence in AF patients after radiofrequency ablation (P<0.05). Receiver operating characteristic curve (ROC) analysis showed that the areas under the curve of serum FGF-23, LAD and their combined detection to predict the recurrence of AF patients after radiofrequency ablation were 0.770 (95%CI: 0.681-0.859), 0.743 (95%CI: 0.651-0.836) and 0.828 (95%CI: 0.752-0.904) respectively. The recurrence rate after radiofrequency ablation was significantly higher in the FGF-23 high expression group (FGF-23≥224.42 μg/L, 56 cases) than that of the FGF-23 low expression group (FGF-23<224.42 μg/L, 76 cases, 44.64% vs. 21.05%, χ²=8.379, P<0.05). Conclusion High serum FGF-23 level is a risk factor for recurrence in AF patients after radiofrequency ablation, and it has high predictive value for recurrence after radiofrequency ablation in patients with AF.

Key words: atrial fibrillation, recurrence, fibroblast growth factor-23, prognoses, radiofrequency ablation

CLC Number:

R541.7+5

Figures/Tables 4

References 20

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组别		n	年龄（岁）	性别（男/女）		BMI （kg/m²）	高血压 [例（%）]		糖尿病 [例（%）]		高脂血症 [例（%）]		吸烟史 [例（%）]		AF类型[例（%）]
组别		n	年龄（岁）	性别（男/女）		BMI （kg/m²）	高血压 [例（%）]		糖尿病 [例（%）]		高脂血症 [例（%）]		吸烟史 [例（%）]		持续性		阵发性
未复发组		91	57.45±11.38	56/35		22.57±2.31	41（45.05）		10（10.99）		30（32.97）		38（41.76）		38（41.76）		53（58.24）
复发组		41	58.31±10.24	22/19		22.75±2.46	21（51.22）		8（19.51）		12（29.27）		19（46.34）		25（60.98）		16（39.02）
t、χ²或Z			0.414	0.726		0.406	0.431		1.744		0.178		0.242		4.184^＊
组别	AST（U/L）				ALT（U/L）			SCr（μmol/L）		BUN（mmol/L）		LVEF		LAD（mm）		FGF-23（μg/L）
未复发组	29.52（18.23，38.92）				27.31（15.33，37.94）			76.97±13.64		5.33±1.74		0.55±0.08		44.87±3.68		202.97±31.28
复发组	28.45（17.61，37.85）				27.69（14.62，36.38）			72.54±15.97		5.69±1.41		0.54±0.06		48.92±4.31		243.69±36.15
t、χ²或Z	0.652				0.158			1.540		1.163		0.358		5.543^＊＊		6.589^＊＊

组别		n	年龄（岁）	性别（男/女）		BMI （kg/m²）	高血压 [例（%）]		糖尿病 [例（%）]		高脂血症 [例（%）]		吸烟史 [例（%）]		AF类型[例（%）]
组别		n	年龄（岁）	性别（男/女）		BMI （kg/m²）	高血压 [例（%）]		糖尿病 [例（%）]		高脂血症 [例（%）]		吸烟史 [例（%）]		持续性		阵发性
未复发组		91	57.45±11.38	56/35		22.57±2.31	41（45.05）		10（10.99）		30（32.97）		38（41.76）		38（41.76）		53（58.24）
复发组		41	58.31±10.24	22/19		22.75±2.46	21（51.22）		8（19.51）		12（29.27）		19（46.34）		25（60.98）		16（39.02）
t、χ²或Z			0.414	0.726		0.406	0.431		1.744		0.178		0.242		4.184^＊
组别	AST（U/L）				ALT（U/L）			SCr（μmol/L）		BUN（mmol/L）		LVEF		LAD（mm）		FGF-23（μg/L）
未复发组	29.52（18.23，38.92）				27.31（15.33，37.94）			76.97±13.64		5.33±1.74		0.55±0.08		44.87±3.68		202.97±31.28
复发组	28.45（17.61，37.85）				27.69（14.62，36.38）			72.54±15.97		5.69±1.41		0.54±0.06		48.92±4.31		243.69±36.15
t、χ²或Z	0.652				0.158			1.540		1.163		0.358		5.543^＊＊		6.589^＊＊

指标	β	SE	Wald χ²	P	OR	95%CI
AF类型	0.894	0.326	7.520	0.006	2.445	1.291~4.632
LAD	0.912	0.418	4.760	0.029	2.489	1.097~5.648
FGF-23	0.934	0.393	5.648	0.017	2.545	1.178~5.497
常数项	0.358	0.118	9.205	0.002	1.135	-

指标	β	SE	Wald χ²	P	OR	95%CI
AF类型	0.894	0.326	7.520	0.006	2.445	1.291~4.632
LAD	0.912	0.418	4.760	0.029	2.489	1.097~5.648
FGF-23	0.934	0.393	5.648	0.017	2.545	1.178~5.497
常数项	0.358	0.118	9.205	0.002	1.135	-

指标	AUC	AUC 95%CI	临界值	敏感度（%）	特异度（%）	约登指数
LAD	0.743	0.651~0.836	46.78 mm	82.93	57.14	0.401
FGF-23	0.770	0.681~0.859	224.42 μg/L	63.41	86.81	0.502
联合	0.828	0.752~0.904	-	80.49	72.53	0.530