Key result
Preoperative CA-125 ≥ 13.75 U/mL is linked to ~254% higher AF recurrence risk following ablation.
Why the study?
Elevated plasma CA-125 levels are linked to new-onset AF and heart failure, but the relationship between plasma CA-125 and AF recurrence following RFCA remains poorly investigated.
Does elevated preoperative CA-125 predict atrial fibrillation recurrence in patients with non-valvular AF undergoing initial radiofrequency catheter ablation?
Cohort (n=353)
No
Does elevated preoperative CA-125 predict atrial fibrillation recurrence in patients with non-valvular AF undergoing initial radiofrequency catheter ablation?
Elevated preoperative CA-125 levels (≥ 13.75 U/mL) serve as an independent predictor for atrial fibrillation recurrence after initial radiofrequency catheter ablation.
CA-125 may aid post-ablation recurrence risk stratification; extends biomarker observations but leaves open prospective validation before practice change.
BACKGROUND: Elevated plasma carbohydrate antigen-125 (CA-125) levels are strongly associated with new-onset atrial fibrillation (AF) and heart failure, but the relationship between plasma CA-125 level and AF recurrence following radiofrequency catheter ablation (RFCA) remains poorly investigated. We aimed to assess whether elevated CA-125 levels are related to long-term AF recurrence following RFCA. METHODS: Preoperative CA-125 levels were determined in AF patients undergoing initial RFCA. Multivariate-adjusted Cox models were constructed to determine the relationship between CA-125 levels and AF recurrence. Multivariate logistic regression analyses were performed to determine predictors of AF recurrence. RESULTS: Of the 353 enrolled patients, 85 patients (24.1%) had AF recurrence at the 12-month follow-up. These patients had significantly higher baseline CA-125 levels than those without AF recurrence [(18.71 ± 12.63) vs. (11.27 ± 5.40) U/mL, P < 0.001]. The incidence of AF recurrence across quartiles 1-4 of CA-125 was 11.5%, 13.3%, 21.6% and 50.0%, respectively (P-trend < 0.001). The adjusted hazard ratios (aHRs) for AF recurrence across quartiles 1-4 of CA-125 were 1.00 (reference), 1.085 (95% CI, 0.468-2.520), 1.866 (95% CI, 0.867-4.019), and 4.246 (95% CI, 2.113-8.533), respectively (P-trend < 0.001). A similar effect was obtained when CA-125 was studied as continuous data (aHR per unit increase in LnCA-125, 3.225, 95% CI, 2.258-4.606; P < 0.001). When a predefined CA-125 cut-off of 13.75 U/mL was established, patients with CA-125 ≥ 13.75 U/mL had a higher risk of recurrent AF than those with CA-125 < 13.75 U/mL (aHR, 3.540, 95% CI, 2.268-5.525, P < 0.001). Multivariate analysis revealed CA-125, high-sensitivity C-reactive protein, and left atrium anteroposterior diameter as independent risk factors for AF recurrence. CONCLUSIONS: Elevated preoperative CA-125 levels are related to a higher risk of AF recurrence and can independently predict AF recurrence following RFCA.
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Wang et al. (2021) conducted a cohort in Atrial fibrillation (n=353). Elevated preoperative CA-125 (≥ 13.75 U/mL) vs. CA-125 < 13.75 U/mL was evaluated on Atrial fibrillation recurrence at 12 months (aHR 3.540, 95% CI 2.268-5.525, p=< 0.001). Preoperative plasma CA-125 levels ≥ 13.75 U/mL were associated with a significantly higher risk of atrial fibrillation recurrence at 12 months following radiofrequency catheter ablation (aHR 3.540).
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