High-density lipoprotein cholesterol to c-reactive protein ratio predicts atrial fibrillation recurrence after...

Area of Science:

• Cardiology
• Biochemistry
• Inflammation Research

Background:

• Atrial fibrillation (AF) recurrence post-cardioversion is a significant clinical challenge.
• Inflammation is recognized as a key factor in AF pathophysiology.
• Novel inflammatory markers are needed for predicting AF recurrence.

Purpose of the Study:

• To evaluate the predictive value of the high-density lipoprotein cholesterol to c-reactive protein (HDL-C/CRP) ratio for AF recurrence after electrical cardioversion (ECV).
• To assess HDL-C/CRP as a potential inflammatory marker for AF recurrence risk stratification.

Main Methods:

• Analysis of 96 patients undergoing elective ECV for AF between June 2020 and December 2023.
• Measurement of baseline HDL-C and CRP levels.
• Statistical analysis including Cox regression, ROC curves, and Kaplan-Meier analysis to assess the association between HDL-C/CRP ratio and AF recurrence.

Main Results:

• AF recurred in 58% of patients post-ECV.
• Patients with AF recurrence had significantly higher CHA₂DS₂-VASc scores, larger left atrial diameters, and lower HDL-C/CRP ratios (p=0.003).
• A lower HDL-C/CRP ratio was identified as an independent predictor of AF recurrence (adjusted HR=0.98; p=0.030), with an AUC of 0.68 (p=0.003). Patients with HDL-C/CRP <7.4 showed higher recurrence rates (p=0.013).

Conclusions:

• The HDL-C/CRP ratio serves as a valuable inflammatory marker for predicting AF recurrence after ECV.
• A lower baseline HDL-C/CRP ratio is associated with an increased risk of AF recurrence.
• This ratio may aid in identifying patients who could benefit from intensified management strategies post-ECV.