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Neopterin and interleukin-6 as predictors of recurrent atrial fibrillation [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(8): 563-571 | DOI: 10.5152/AnatolJCardiol.2015.6272

Neopterin and interleukin-6 as predictors of recurrent atrial fibrillation

Ewa Lewicka1, Julita Dudzinska-gehrmann2, Alicja Dabrowska-kugack1, Pawel Zagozd3, Aleksandra Lizewska1, Ludmila Danilowicz-szymanowicz1, Grzegorz Raczak1
1Department of Cardiology and Electrotherapy Medical University of Gdansk, Epidemiology Medical University of Gdansk, Gdansk- Poland
2Department of Cardiology MSW Hospital in Gdansk, Epidemiology Medical University of Gdansk, Gdansk- Poland
3Department of Hygiene and Epidemiology Medical University of Gdansk, Gdansk- Poland

Objective: Available evidence suggests that inflammation may be associated with atrial fibrillation (AF). This prospective and observational study aimed to assess whether plasma neopterin (NPT) and interleukin-6 (IL-6) levels before and after electrical cardioversion (CV) predict AF recurrence.
Methods: The study was designed as a prospective observational trial. Blood samples were collected (24 hours before, 24 h after CV, and 7 days after CV) in 60 patients with a dual-chamber pacemakar and preserved left ventricular systolic function who underwent successful CV of persistent AF. All significant parameters associated with AF recurrence lasting ≥30 min and detected by pacemaker data logs were evaluated in multivariate logistic regression analysis. Echocardiography was performed 7 days after CV in patients with sinus rhythm. The control group included 17 subjects without AF.
Results: The analysis included 51 patients who remained in sinus rhythm 7 days after CV. During 12 months of follow-up, AF recurred in 46 patients. Baseline IL-6 levels did not differ between the two groups, but baseline NPT levels were higher in the study group than in the control group (19±7 vs. 11±5 nmol/mL, p<0.001). NPT levels of ≥14.6 nmol/L at baseline and ≥13.3 nmol/L 7 days after CV separated the patients with AF recurrence from those without arrhythmia after CV. Only left atrial emptying fraction <38% was an independent predictor of AF recurrence (p=0.03), whereas NPT levels of ≥13.3 nmol/L 7 days after CV showed borderline statistical significance (p=0.07).
Conclusion: Increased NPT level was observed in patients with persistent AF. Neither baseline IL-6 and NPT levels nor their changes within 7 days after CV were predictive of AF recurrence. Further studies are needed to establish the prognostic significance of NPT in patients with AF. (Anatol J Cardiol 2016; 16: 000-000)

Keywords: atrial fibrillation, recurrence, neopterin, interleukin-6

Ewa Lewicka, Julita Dudzinska-gehrmann, Alicja Dabrowska-kugack, Pawel Zagozd, Aleksandra Lizewska, Ludmila Danilowicz-szymanowicz, Grzegorz Raczak. Neopterin and interleukin-6 as predictors of recurrent atrial fibrillation. Anatol J Cardiol. 2016; 16(8): 563-571

Corresponding Author: Aleksandra Lizewska, Poland