Abstract 14072: Preferential Association of Biomarkers With Non-paroxysmal Atrial Fibrillation Indicates The Role of Inflammation in Persistence of the Arrhythmia
Introduction: Compelling evidences suggest the association between atrial fibrillation (AF) and inflammation although it is yet to be established whether it has a causal link with the origin of AF or it is more closely related with the perpetuation of AF. This study evaluated several biomarkers in AF patients with the aim to determine if inflammation is involved in the causation or persistence of this arrhythmia.
Methods: This prospective pilot study (IMPACT) enrolled 48 consecutive AF patients undergoing their first catheter ablation (age 63±5 year, 71% male, paroxysmal 39%, persistent 46%, long-standing persistent AF 15%, BMI 31±6). Patients with chronic inflammatory conditions or taking anti-inflammatory drugs were excluded. Fasting blood samples were collected within 24-hours pre-ablation.
Results: Baseline blood samples were analyzed for CKMB, Interferon-gamma (INF-γ), myoglobin, NT-proBNP, and tissue-inhibitors of matrix-metalloproteinase (TIMP 1) by ELISA assay. The biomarker levels were significantly higher in the non-paroxysmal (non-PAF) group compared to the PAF population (CKMB 1.7 vs. 3.6, p=0.022, INF-γ 1.6 vs. 6.1, p=0.01, myoglobin 73.4 VS. 125.6, p= 0.01, NT-proBNP 1493 vs. 2193, P=0.04 and TIMP1 142 vs. 176, p=0.027). After adjusting for gender, age and LA size, non-PAF was independently associated with higher biomarker level; odds ratio for CKMB, INF-γ, INF-γ, myoglobin, NT-proBNP, and TIMP1 were 01.27 (p= .031), 01.30 (p= .026), 01.74(p= .013), 1.42(p=.016), and 1.12(p=.017) respectively.
Conclusion: Association of specific inflammatory biomarkers such as CKMB, myoglobin, INF- γ, NT-proBNP and TIMP 1 with non-PAF cohort and not with PAF population indicates the link between inflammation and AF persistence. This association is most plausibly mediated via induction of structural remodeling of the atrium by inflammation and oxidative stress.
- © 2013 by American Heart Association, Inc.