The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation

Background The difference between the cystatin C-based eGFR (eGFRcys) and the creatinine-based eGFR (eGFRcr) is associated with the risk of developing atrial fibrillation (AF) risk. However, its impact on AF ablation outcomes is unknown.Methods The associations between the baseline eGFR ratio (eGFRc...

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Main Authors: Wenchao Huang, Luxiang Shang, Yan Luo, Shiqiang Xiong, Shuwei Suo, Zhen Zhang, Hanxiong Liu, Huaxin Sun
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2466824
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author Wenchao Huang
Luxiang Shang
Yan Luo
Shiqiang Xiong
Shuwei Suo
Zhen Zhang
Hanxiong Liu
Huaxin Sun
author_facet Wenchao Huang
Luxiang Shang
Yan Luo
Shiqiang Xiong
Shuwei Suo
Zhen Zhang
Hanxiong Liu
Huaxin Sun
author_sort Wenchao Huang
collection DOAJ
description Background The difference between the cystatin C-based eGFR (eGFRcys) and the creatinine-based eGFR (eGFRcr) is associated with the risk of developing atrial fibrillation (AF) risk. However, its impact on AF ablation outcomes is unknown.Methods The associations between the baseline eGFR ratio (eGFRcys/eGFRcr) and the risk of experiencing post-ablation endpoints were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. The primary endpoints were AF recurrence and adverse events; the secondary endpoint was rehospitalization.Results Among 989 participants (49.2% women; mean age 65.7 years), 313 experienced AF recurrence after a median follow-up of 28 months. After full adjustment for confounding factors, a U-shaped association was observed between eGFR ratio and AF recurrence risk (minimum risk at 0.797). Although a U-shaped trend was observed, there was no statistically significant association between the eGFR ratio and adverse events or rehospitalization. Hazard ratios for AF recurrence, compared to the second quartile, were 1.68 (1.20–2.37) for the first quartile, 1.64 (1.15–2.34) for the third quartile, and 1.96 (1.37–2.80) for the fourth quartile. According to the subgroup analysis, the above association was strongly U-shaped for males and linear for females.Conclusion In the AF population, both low and high eGFR ratios were associated with an increased risk of post-ablation AF recurrence.
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spelling doaj-art-86c67e71f1144eb3a0d9839b791ba7c92025-08-20T03:05:45ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2466824The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillationWenchao Huang0Luxiang Shang1Yan Luo2Shiqiang Xiong3Shuwei Suo4Zhen Zhang5Hanxiong Liu6Huaxin Sun7Department of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaDepartment of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, Shandong, ChinaDepartment of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaDepartment of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaDepartment of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaDepartment of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaDepartment of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaDepartment of Cardiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, ChinaBackground The difference between the cystatin C-based eGFR (eGFRcys) and the creatinine-based eGFR (eGFRcr) is associated with the risk of developing atrial fibrillation (AF) risk. However, its impact on AF ablation outcomes is unknown.Methods The associations between the baseline eGFR ratio (eGFRcys/eGFRcr) and the risk of experiencing post-ablation endpoints were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. The primary endpoints were AF recurrence and adverse events; the secondary endpoint was rehospitalization.Results Among 989 participants (49.2% women; mean age 65.7 years), 313 experienced AF recurrence after a median follow-up of 28 months. After full adjustment for confounding factors, a U-shaped association was observed between eGFR ratio and AF recurrence risk (minimum risk at 0.797). Although a U-shaped trend was observed, there was no statistically significant association between the eGFR ratio and adverse events or rehospitalization. Hazard ratios for AF recurrence, compared to the second quartile, were 1.68 (1.20–2.37) for the first quartile, 1.64 (1.15–2.34) for the third quartile, and 1.96 (1.37–2.80) for the fourth quartile. According to the subgroup analysis, the above association was strongly U-shaped for males and linear for females.Conclusion In the AF population, both low and high eGFR ratios were associated with an increased risk of post-ablation AF recurrence.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2466824Atrial fibrillationablationestimated glomerular filtration ratecystatin Ccreatinine
spellingShingle Wenchao Huang
Luxiang Shang
Yan Luo
Shiqiang Xiong
Shuwei Suo
Zhen Zhang
Hanxiong Liu
Huaxin Sun
The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation
Renal Failure
Atrial fibrillation
ablation
estimated glomerular filtration rate
cystatin C
creatinine
title The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation
title_full The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation
title_fullStr The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation
title_full_unstemmed The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation
title_short The association between the cystatin C- and creatinine-based estimated GFR ratio and post-ablation outcomes in patients with atrial fibrillation
title_sort association between the cystatin c and creatinine based estimated gfr ratio and post ablation outcomes in patients with atrial fibrillation
topic Atrial fibrillation
ablation
estimated glomerular filtration rate
cystatin C
creatinine
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2466824
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