Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Dec 26, 2024; 16(12): 740-750
Published online Dec 26, 2024. doi: 10.4330/wjc.v16.i12.740
Role of a new inflammation predictor in predicting recurrence of atrial fibrillation after radiofrequency catheter ablation
Yu-Jie Wang, Ke-Sen Liu, Xiang-Jiang Meng, Xue-Fu Han, Lu-Jing Nie, Wen-Jiu Feng, Yan-Bo Chen
Yu-Jie Wang, Xiang-Jiang Meng, Department of Cardiology, Changle People’s Hospital, Shandong Second Medical University Affiliated Hospital, Weifang 261000, Shandong Province, China
Ke-Sen Liu, Xue-Fu Han, Lu-Jing Nie, Wen-Jiu Feng, Yan-Bo Chen, Department of Arrhythmia, Weifang People's Hospital, Weifang 261000, Shandong Province, China
Author contributions: Wang YJ, Nie LJ, Han XF and Feng WJ contributed to the resources of this manuscript; Wang YJ, Liu KS, and Meng XJ participated in the writing-original draft of this article; Wang YJ, Han XF, and Liu KS were involved in the visualization; Wang YJ, Liu KS, Meng XJ, and Chen YB took part in the writing, review, and editing; Wang YJ, Liu KS, Meng XJ and Chen YB contributed to the conceptualization and methodology of this manuscript; Chen YB participated in the supervision of this study; Wang YJ and Liu KS contributed to the software and formal analysis of this manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of Weifang People’s Hospital and was conducted in accordance with the Declaration of Helsinki.
Informed consent statement: Due to the retrospective nature of this study, the Ethics Committee waived the requirement for informed consent from the participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data presented in this study are available on request from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Bo Chen, MD, Chief Physician, Department of Arrhythmia, Weifang People's Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang 261000, Shandong Province, China. hhg1020172021@163.com
Received: August 5, 2024
Revised: September 27, 2024
Accepted: October 29, 2024
Published online: December 26, 2024
Processing time: 112 Days and 20.5 Hours
Abstract
BACKGROUND

Radiofrequency catheter ablation (RFCA) has become an important strategy for treating atrial fibrillation (AF), and postoperative recurrence represents a significant and actively discussed clinical concern. The recurrence after RFCA is considered closely related to inflammation. Systemic immune inflammation index (SII) is a novel inflammation predictor based on neutrophils, platelets, and lymphocytes, and is considered a biomarker that comprehensively reflects the immune inflammatory status of the body.

AIM

To explore the predictive effect of the SII on AF recurrence after RFCA and its predictive value in combination with the existing APPLE score for AF recurrence after RFCA in patients with non-valvular AF (NVAF).

METHODS

We retrospectively included 457 patients with NVAF first receiving RFCA and classified them into the recurrent or non-recurrent group. We also investigated the predictive role of SII on AF recurrence following RFCA. Finally, we explored and compared the additional predictive value of the SII after combining with the APPLE score.

RESULTS

After 12 months of follow-up, 113 (24.7%) patients experienced recurrence. High SII has been demonstrated to be an independent predictor for postoperative AF recurrence. Receiver operating characteristic and decision curve analysis (DCA), as well as net reclassification improvement (NRI) and integrated discrimination improvement (IDI) results, showed that SII combined with the APPLE score had higher predictive efficiency than using the SII or APPLE score alone. The area under the curve of the combined model (0.662, 95% confidence interval: 0.602-0.722) significantly increased compared with that of the SII and APPLE scores alone (P < 0.001). The combined model resulted in an NRI of 29.6% and 34.1% and IDI of 4.9% and 3.5% in predicting AF recurrence compared with the SII and APPLE scores alone, respectively (all P < 0.001). The SII, APPLE score, and their combination demonstrated greater clinical utility than did the treat-all and treat-none strategies over the 20–80% risk threshold according to the DCA.

CONCLUSION

The SII was a predictor of recurrence after RFCA of AF. Moreover, the SII enhanced the predictability of the APPLE score for post-RFCA AF recurrence, providing valuable insights for physicians to optimise patient selection and develop personalised treatment plans.

Keywords: Systemic immune inflammation index; Atrial fibrillation; Radiofrequency catheter ablation; APPLE score; Recurrence

Core Tip: We explored the role of the systemic immune inflammation index (SII) in predicting recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We show that the SII is a predictive factor for postoperative recurrence of AF after RFCA and enhances the ability of the APPLE score to predict postoperative recurrence of AF.