Growth Differentiation Factor 15 Level Changes in the Early and Late Periods After Radiofrequency Catheter Ablation of Atrial Fibrillation
摘要
GDF-15 (growth differentiation factor 15) is a protein from the transforming growth factor β (TGF-β) cytokine family. In patients with atrial fibrillation (AF), GDF-15 is a potent marker of bleeding adverse events in anticoagulated patients and a predictor of overall mortality. The study aimed to describe the early and late dynamics of GDF-15 after radiofrequency catheter ablation (RFCA) of AF.
MethodsWe enrolled 50 patients (median 65 (57; 69) years, 64% males) undergoing RFCA of AF. Sequential blood takes (before RFCA—baseline, right after RFCA (0 h), 24 and 48 h, 3, and 6 months after RFCA) were analyzed.
ResultsOut of all patients, 20 (40%) had paroxysmal AF. Pulmonary vein isolation was completed in 48 (96% of patients), and additional left or right atrium lesions were done in 24 (49%) patients. The median (IQR) GDF-15 level at the baseline was 993 (707; 1342) ng/L. GDF-15 level peak was registered 24 h after ablation with a median of 1182 (821; 1899) ng/L. Compared to patients with paroxysmal AF, those subjects with non-paroxysmal AF had GDF-15 levels significantly higher at baseline (812 (580; 1040) vs 1217 (832; 1836) ng/L, p = 0.002). In patients with paroxysmal AF, GDF-15 values decreased to 3 months after RFCA (679 (554; 1133) ng/L). Higher GDF-15 levels persist over 90 days from ablation in patients with non-paroxysmal AF (1189 (893; 1851) ng/L).
ConclusionAlthough GDF-15 is considered a nonspecific biomarker reflecting the patient's general condition, its levels are significantly affected by the RFCA of AF.