Elevated baseline concentrations of NT-proBNP (HR 1.58; 95% CI 1.29-1.94), ANGPT2, and BMP10 were associated with recurrent atrial fibrillation during the first 3 months after a first AF ablation.
RCT (n=433)
Are elevated baseline concentrations of specific cardiovascular biomolecules associated with recurrent AF after a first AF ablation?
Elevated baseline concentrations of ANGPT2, BMP10, and NT-proBNP are associated with recurrent AF within 3 months after a first AF ablation, suggesting roles for disturbed metabolism, shear stress, and cardiac load.
Effect estimate: HR 1.58 (95% CI 1.29-1.94)
AIMS: Different disease processes can combine to cause atrial fibrillation (AF). Their contribution to recurrent AF after ablation in patients is not known. Cardiovascular processes associated with recurrent AF after AF ablation were determined by quantifying biomolecules related to inflammation, metabolism, proliferation, fibrosis, shear stress, atrial pressure, and others in the AXAFA biomolecule study. METHODS AND RESULTS: Twelve circulating cardiovascular biomolecules (ANGPT2, BMP10, CA125, hsCRP, ESM1, FABP3, FGF23, GDF15, IGFBP7, IL6, NT-proBNP, and hsTnT) were quantified in plasma samples obtained prior to a first AF ablation using high-throughput, high-precision assays. Cox regression was used to identify biomolecules associated with recurrent AF during the first 3 months after AF ablation. In 433 patients (64 years 58, 70; 33% women), baseline concentrations of ANGPT2, BMP10, hsCRP, FGF23, FABP3, GDF15, and NT-proBNP were elevated in patients with recurrent AF (120/433; 28%). After adjustment for 11 clinical features and randomized treatment, elevated NT-proBNP hazard ratio (HR) 1.58, 95% confidence interval (1.29, 1.94), ANGPT2 HR 1.37, (1.12, 1.67), and BMP10 HR 1.24 (1.02, 1.51) remained associated with recurrent AF. Concentrations of ANGPT2, BMP10, and NT-proBNP decreased in patients who remained arrhythmia free, but not in patients with recurrent AF, highlighting their connection to AF. The other eight biomarkers showed unchanged concentrations. CONCLUSION: Elevated concentrations of ANGPT2, BMP10, and NT-proBNP are associated with recurrent AF after a first AF ablation, suggesting that processes linked to disturbed cardiomyocyte metabolism, altered atrial shear stress, and increased load contribute to AF after AF ablation in patients.
Chua et al. (Wed,) conducted a rct in Atrial fibrillation after ablation (n=433). Elevated baseline cardiovascular biomolecules (NT-proBNP, ANGPT2, BMP10) vs. Normal or unchanged biomarker concentrations was evaluated on Recurrent AF during the first 3 months after AF ablation (HR 1.58, 95% CI 1.29-1.94). Elevated baseline concentrations of NT-proBNP (HR 1.58; 95% CI 1.29-1.94), ANGPT2, and BMP10 were associated with recurrent atrial fibrillation during the first 3 months after a first AF ablation.