TY - JOUR
T1 - High circulating adiponectin level is associated with poor clinical outcome after catheter ablation for paroxysmal atrial fibrillation
AU - Kim, Tae Hoon
AU - Lee, Jihei Sara
AU - Uhm, Jae Sun
AU - Joung, Boyoung
AU - Lee, Moon Hyoung
AU - Pak, Hui Nam
N1 - Publisher Copyright:
© 2017 The Author(s).
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Aims: Circulating adiponectin is known to have anti-diabetic, anti-atherogenic, and anti-inflammatory properties. However, the predictive value of adiponectin in cardiovascular disease has been reported to be contradictory ('adiponectin paradox') and its relationship with atrial fibrillation (AF) is controversial. We hypothesized that preprocedural plasma level of adiponectin would have prognostic value in patients who underwent AF catheter ablation. Methods and results: This observational cohort study included 874 patients with paroxysmal AF (PAF) (73.0% male, mean age 57.6 ± 11.2 years) who underwent catheter ablation. Quartile analyses of plasma level of adiponectin were performed to determine AF-related clinical factors. Patients in the highest quartile of plasma adiponectin were more likely to be older (P < 0.001), female (P < 0.001), and have a higher CHA2DS2-VASc score (P < 0.001) than patients in the other three quartiles. Plasma level of adiponectin was independently associated with female gender (B 2.92 [1.84∼4.00], P < 0.001), older age (B 0.06 [0.03∼0.10], P < 0.001), lower body mass index (B - 0.22 [-0.42∼-0.03], P = 0.025), and greater LA volume index (B 0.05 [0.01∼0.08], P = 0.005). During the 29.9 ± 18.0 months of follow-up, plasma adiponectin level (HR 1.17 [1.02∼1.35], P = 0.022) was independently associated with clinical recurrence of AF, and the clinical recurrence rate was significantly higher in the highest quartile of adiponectin group than the others (log rank P = 0.029), especially in age <65 years (log rank P=0.038), but not in age ≥65. Conclusion: High circulating adiponectin is independently associated with AF recurrence after catheter ablation for PAF, especially younger than 65 years old.
AB - Aims: Circulating adiponectin is known to have anti-diabetic, anti-atherogenic, and anti-inflammatory properties. However, the predictive value of adiponectin in cardiovascular disease has been reported to be contradictory ('adiponectin paradox') and its relationship with atrial fibrillation (AF) is controversial. We hypothesized that preprocedural plasma level of adiponectin would have prognostic value in patients who underwent AF catheter ablation. Methods and results: This observational cohort study included 874 patients with paroxysmal AF (PAF) (73.0% male, mean age 57.6 ± 11.2 years) who underwent catheter ablation. Quartile analyses of plasma level of adiponectin were performed to determine AF-related clinical factors. Patients in the highest quartile of plasma adiponectin were more likely to be older (P < 0.001), female (P < 0.001), and have a higher CHA2DS2-VASc score (P < 0.001) than patients in the other three quartiles. Plasma level of adiponectin was independently associated with female gender (B 2.92 [1.84∼4.00], P < 0.001), older age (B 0.06 [0.03∼0.10], P < 0.001), lower body mass index (B - 0.22 [-0.42∼-0.03], P = 0.025), and greater LA volume index (B 0.05 [0.01∼0.08], P = 0.005). During the 29.9 ± 18.0 months of follow-up, plasma adiponectin level (HR 1.17 [1.02∼1.35], P = 0.022) was independently associated with clinical recurrence of AF, and the clinical recurrence rate was significantly higher in the highest quartile of adiponectin group than the others (log rank P = 0.029), especially in age <65 years (log rank P=0.038), but not in age ≥65. Conclusion: High circulating adiponectin is independently associated with AF recurrence after catheter ablation for PAF, especially younger than 65 years old.
KW - Adiponectin
KW - Atrial fibrillation
KW - Catheter ablation
KW - Recurrence
KW - Very late recurrence
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U2 - 10.1093/europace/eux173
DO - 10.1093/europace/eux173
M3 - Article
C2 - 29016783
AN - SCOPUS:85055466901
SN - 1099-5129
VL - 20
SP - 1287
EP - 1293
JO - Europace
JF - Europace
IS - 8
ER -