Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study

Objective Collect the characteristics of patients’ baseline data, and explore the predictive factors of late recurrence of atrial fibrillation (AF) after catheter ablation according to whether late recurrence or not. The purpose of this study was to determine the significance of the APPLE score in c...

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Main Authors: Zhe Xu, Yi Chen, Xue-Hai Chen, Jian-Hua Chen, Ke-Zeng Gong, Wei-Wei Wang, Fei-Long Zhang
Format: Article
Language:English
Published: BMJ Publishing Group 2024-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/8/e081808.full
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author Zhe Xu
Yi Chen
Xue-Hai Chen
Jian-Hua Chen
Ke-Zeng Gong
Wei-Wei Wang
Fei-Long Zhang
author_facet Zhe Xu
Yi Chen
Xue-Hai Chen
Jian-Hua Chen
Ke-Zeng Gong
Wei-Wei Wang
Fei-Long Zhang
author_sort Zhe Xu
collection DOAJ
description Objective Collect the characteristics of patients’ baseline data, and explore the predictive factors of late recurrence of atrial fibrillation (AF) after catheter ablation according to whether late recurrence or not. The purpose of this study was to determine the significance of the APPLE score in conjunction with the monocyte–high-density lipoprotein cholesterol ratio (MHR) in predicting the late recurrence of AF after catheter ablation in patients with AF.Methods Baseline data were collected to explore the predictors of late recurrence after AF catheter ablation. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to compare the predictive value of MHR, the APPLE score and their combined variables in the late recurrence of AF after catheter ablation.Results This is a retrospective study. A total of 438 patients were followed-up, including 303 cases of paroxysmal AF, 135 cases of persistent AF (28 cases of long-term persistent AF) and 115 cases of late recurrence. The Cox multivariate regression analysis revealed that MHR, the APPLE score and early recurrence were independent predictors of the late recurrence of AF. The AUC of the combined variables for predicting late recurrence after catheter ablation in patients with AF was higher than that of MHR and the APPLE score (p<0.05). The ROC AUC of the combined variables in predicting the late recurrence of AF after catheter ablation was 0.733 (p<0.001, 95% CI: 0.660 to 0.806), and the best cut-off point was 0.2711 (sensitivity: 69.20%, specificity: 68.00%).Conclusions Early recurrence, MHR and the APPLE score are independent risk factors for the late recurrence of AF after catheter ablation. The combination of the APPLE score with MHR improved the value of predicting the late recurrence of AF after catheter ablation. The combined variables were a predictor of an increased late recurrence rate after catheter ablation for AF when the value was greater than 0.2711.
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spelling doaj-art-7a6fda1a925847ebbd9873b001e57b942025-08-20T02:36:44ZengBMJ Publishing GroupBMJ Open2044-60552024-08-0114810.1136/bmjopen-2023-081808Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective studyZhe Xu0Yi Chen1Xue-Hai Chen2Jian-Hua Chen3Ke-Zeng Gong4Wei-Wei Wang5Fei-Long Zhang6China National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Cardiology, the Affiliated Hospital of Putian University, Licheng District Putian, ChinaDepartment of Cardiology, Fujian Medical University Union Hospital, Fujian Clinical Medical Research Center for Heart and Macrovascular Diseases, Fujian Heart Medical Center, Fuzhou, ChinaDepartment of Cardiology, Fujian Medical University Union Hospital, Fujian Clinical Medical Research Center for Heart and Macrovascular Diseases, Fujian Heart Medical Center, Fuzhou, ChinaDepartment of Cardiology, Fujian Medical University Union Hospital, Fujian Clinical Medical Research Center for Heart and Macrovascular Diseases, Fujian Heart Medical Center, Fuzhou, ChinaDepartment of Cardiology, Fujian Medical University Union Hospital, Fujian Clinical Medical Research Center for Heart and Macrovascular Diseases, Fujian Heart Medical Center, Fuzhou, ChinaDepartment of Cardiology, Fujian Medical University Union Hospital, Fujian Clinical Medical Research Center for Heart and Macrovascular Diseases, Fujian Heart Medical Center, Fuzhou, ChinaObjective Collect the characteristics of patients’ baseline data, and explore the predictive factors of late recurrence of atrial fibrillation (AF) after catheter ablation according to whether late recurrence or not. The purpose of this study was to determine the significance of the APPLE score in conjunction with the monocyte–high-density lipoprotein cholesterol ratio (MHR) in predicting the late recurrence of AF after catheter ablation in patients with AF.Methods Baseline data were collected to explore the predictors of late recurrence after AF catheter ablation. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to compare the predictive value of MHR, the APPLE score and their combined variables in the late recurrence of AF after catheter ablation.Results This is a retrospective study. A total of 438 patients were followed-up, including 303 cases of paroxysmal AF, 135 cases of persistent AF (28 cases of long-term persistent AF) and 115 cases of late recurrence. The Cox multivariate regression analysis revealed that MHR, the APPLE score and early recurrence were independent predictors of the late recurrence of AF. The AUC of the combined variables for predicting late recurrence after catheter ablation in patients with AF was higher than that of MHR and the APPLE score (p<0.05). The ROC AUC of the combined variables in predicting the late recurrence of AF after catheter ablation was 0.733 (p<0.001, 95% CI: 0.660 to 0.806), and the best cut-off point was 0.2711 (sensitivity: 69.20%, specificity: 68.00%).Conclusions Early recurrence, MHR and the APPLE score are independent risk factors for the late recurrence of AF after catheter ablation. The combination of the APPLE score with MHR improved the value of predicting the late recurrence of AF after catheter ablation. The combined variables were a predictor of an increased late recurrence rate after catheter ablation for AF when the value was greater than 0.2711.https://bmjopen.bmj.com/content/14/8/e081808.full
spellingShingle Zhe Xu
Yi Chen
Xue-Hai Chen
Jian-Hua Chen
Ke-Zeng Gong
Wei-Wei Wang
Fei-Long Zhang
Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
BMJ Open
title Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
title_full Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
title_fullStr Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
title_full_unstemmed Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
title_short Significance of the APPLE score and the monocyte–HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
title_sort significance of the apple score and the monocyte hdl cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study
url https://bmjopen.bmj.com/content/14/8/e081808.full
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