Key result
High homocysteine linked to a higher rate of CV events without AF recurrence.
Why the study?
Are high baseline homocysteine levels associated with increased cardiovascular events or AF recurrence following radiofrequency catheter ablation in patients with AF?
Observational (n=96)
Are high baseline homocysteine levels associated with increased cardiovascular events or AF recurrence following radiofrequency catheter ablation in patients with AF?
p-value: p=< 0.05
High baseline homocysteine levels are associated with persistent AF and an increased risk of cardiovascular events following radiofrequency catheter ablation.
High homocysteine signals excess CV events post-AF ablation without recurrence; hypothesis-generating and should not yet change practice.
AIMS: This study investigated the potential association between homocysteine levels and cardiovascular events or atrial fibrillation (AF) recurrence following radiofrequency catheter ablation (RFCA) in patients with AF. METHODS AND RESULTS: Blood samples were obtained prior to the RFCA procedure. Levels of homocysteine and carboxy-terminal telopeptide of collagen type I (CITP), a collagen type I degradation marker, were measured in 96 patients receiving RFCA; 62 paroxysmal or persistent AF patients and 34 paroxysmal supra-ventricular tachycardia patients. Patients were followed up for 2.1 +/- 1.5 years. Plasma homocysteine levels were significantly higher in patients with persistent AF (P < 0.05) compared with levels in paroxysmal AF and control patients. Homocysteine levels also positively correlated with left atrial dimension (LAD) (P < 0.01) and CITP levels (P < 0.001). While no significant correlation was found between basal homocysteine levels and recurrent AF after RFCA in AF patients, patients in the high homocysteine group exhibited a significantly higher rate of cardiovascular events without AF recurrence compared with those in the low homocysteine group (P < 0.05). CONCLUSION: High homocysteine levels are associated with the presence of persistent AF, which is accompanied by increased CITP levels and LAD. Also confirmed is the role of homocysteine as a risk factor for the pathogenesis of cardiovascular events after RFCA in AF patients. Measurement of homocysteine level may provide useful information for the managing cardiovascular risk in patients with AF.
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Shimano et al. (2008) conducted an observational in Atrial fibrillation (n=96). High homocysteine levels vs. Low homocysteine levels was evaluated on Cardiovascular events without AF recurrence (p=< 0.05). High homocysteine levels were associated with a significantly higher rate of cardiovascular events without AF recurrence compared with low homocysteine levels (P < 0.05).
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