AUTHOR=Li Haiwei , Sun Weiping , Wang Zefeng , Wang Ziyu , Du Xiao , Chen Junjun , Gao Jianwei , Liu Xuxia , Wang Xipeng , Wang Yueli , Wu Yongquan , Zhang Xiaoping 

TITLE=Higher serum tissue inhibitor of metalloproteinase-1 predicts atrial fibrillation recurrence after radiofrequency catheter ablation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.961914

DOI=10.3389/fcvm.2022.961914

ISSN=2297-055X

ABSTRACT=Abstract
Background: Tissue inhibitor of metalloproteinase-1 (TIMP-1) levels are strongly associated with cardiac extracellular matrix accumulation and atrial fibrosis. Whether serum levels of TIMP-1 are associated with atrial fibrillation (AF) recurrence following radiofrequency catheter ablation (RFCA) remains unknown.
Methods: Serum TIMP-1 levels of AF patients before they underwent initial RFCA were measured using ELISA. Univariate and Multivariate-adjusted Cox models were constructed to determine the relationship between TIMP-1 levels and AF recurrence. Multivariate logistic regression analyses were performed to determine predictors of AF recurrence.
Results: Of the 194 enrolled patients, 61 (31.4%) had AF recurrence within the median 30.0 months (interquartile range: 16.5–33.7 months) of follow-up. These patients had significantly higher baseline TIMP-1 levels than those without AF recurrence (129.8±65.7 vs. 112.0±51.0 ng/ml, P=0.041). The same was true of high-sensitivity C-reactive protein (3.9±6.0 vs. 1.9±2.8 ng/ml, P=0.001). When a TIMP-1 cutoff of 124.15 ng/ml was set, patients with TIMP-1 ≥ 124.15 ng/ml had a higher risk of recurrent AF than those with TIMP-1 <124.15 ng/ml (HR, 1.961, 95% CI, 1.182–2. 253, P= 0.009). Multivariate Cox regression analysis revealed that high TIMP-1 was an independent risk factor for AF recurrence. Univariate Cox regression analysis found that substrate modification surgery does not affect AF recurrence (P=0.553). Subgroup analysis revealed that female sex, age<65 years, HTN, BMI≥24 kg/m2, CHA2DS2-VASc score<2, HAS-BLED score<3, and EHRA score=3 combined with high TIMP-1 level would perform well at predicting AF recurrence after RFCA.
Conclusion: Elevated preoperative TIMP-1 levels are related to a higher risk of AF recurrence and can independently predict AF recurrence following RFCA.