Abstract 15067: Haptoglobin Level at 24-Hour Post-Ablation Period Predicts Long-Term Recurrence-Free Survival in Atrial Fibrillation-Results From a Prospective Study (IMPACT)
Introduction: Inflammatory activation follows catheter ablation in AF. Haptoglobin (Hp), an acute phase reactant, is released in response to inflammatory stimulus. This study examined the role of Hp in predicting long-term procedure-outcome in AF patients.
Methods: Forty-eight patients (age 63±5 year, 71% male, PAF 39%) undergoing catheter ablation were enrolled in this prospective study. Fasting blood samples collected at baseline and 24-hours post-procedure were analyzed using a quantitative immunoassay technique. Patients were followed up for 12±3 months at 3-months interval with cardiology evaluation, 12-lead ECG and 7-day Holter monitoring.
Results: Hp level at 24-hour post-ablation (Hp24) was 1.3±0.7 mg/ml. At 12±3 month follow-up 31 (65%) patients were arrhythmia-free off-AAD. Recurrence-free patients had significantly higher Hp24 level compared to those who failed (1.5±0.69 vs. 1.05±0.64 mg/ml, p=0.037). An increase in Hp24 was associated with lower recurrence (adjusted odds ratio 0.32(0.11-0.92), p= .034). The receiver operating characteristic (ROC) analysis of multivariable prediction model showed that an Hp24 cut-off value ≥0.93 mg/ml predicted recurrence with 79% sensitivity and 51% specificity (AUC=0.716). After adjusting for age, sex, AF type, dyslipidemia, and obstructive sleep apnea, patients with Hp24 ≥0.93 had about 80% lower risk for AF recurrence compared to those <0.93 (HR 0.21, 0.05-0.75, p=.016). The success rate was in 82% in ≥0.93 and 37% in <0.93 group (log-rank p<.001, figure).
Conclusion: Increased level of Hp immediately following AF-ablation is associated with higher long-term recurrence-free survival. This can be attributed to its potent anti-oxidant activity.
- © 2013 by American Heart Association, Inc.