Horm Metab Res 2025; 57(03): 177-188
DOI: 10.1055/a-2453-4113
Original Article: Endocrine Care
Biao Li
1
Department of Cardiology, Guangzhou Red Cross Hospital,
Guangzhou, China (Ringgold ID: RIN74714)
,
Fang Zeng
1
Department of Cardiology, Guangzhou Red Cross Hospital,
Guangzhou, China (Ringgold ID: RIN74714)
,
Qiang Zhao
1
Department of Cardiology, Guangzhou Red Cross Hospital,
Guangzhou, China (Ringgold ID: RIN74714)
› Author AffiliationsSupported by:
Guangzhou Science and Technology Plan Project
202201020020
Supported by:
Guangzhou School (College) and Enterprise Joint Funding Project
2024A03J0654
› Further Information
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Abstract
The relationship between serum homocysteine (Hcy) levels and atrial fibrillation
(AF) recurrence following catheter ablation remains unclear. This meta-analysis
aims to investigate this association. Comprehensive searches in PubMed, Web of
Science, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI)
databases identified relevant studies published up to May 25, 2024. Cohort
studies that measured pre-ablation serum Hcy levels and reported AF recurrence
post-ablation were included. Data were analyzed using random-effects models by
incorporating the potential influence of heterogeneity, with odds ratios (ORs)
and 95% confidence intervals (CIs) calculated for the association between serum
Hcy levels and AF recurrence. Eleven retrospective cohort studies involving 2147
patients with AF who underwent catheter ablation were analyzed. Higher
pre-ablation serum Hcy levels were associated with an increased risk of AF
recurrence (OR for per 1 μmol/l increment of Hcy: 1.22, 95% CI: 1.17 to 1.28,
p<0.001; I²=0%). Additionally, studies that categorized Hcy levels also found
a higher risk of AF recurrence in patients with elevated Hcy (OR for patients
with a high versus a low serum Hcy: 2.75, 95% CI: 2.02 to 3.75, p <0.001;
I²=0%). Funnel plots and Egger’s regression test indicated low risks of
publication bias. In conclusions, elevated pre-ablation serum Hcy levels are
significantly associated with an increased risk of AF recurrence post-catheter
ablation. These findings suggest that Hcy could be a valuable biomarker for
predicting AF recurrence and may inform pre-ablation risk stratification.
Further prospective studies are warranted to confirm these results.
Keywords
homocysteine -
atrial fibrillation -
catheter ablation -
recurrence -
meta-analysis
Publication History
Received: 18 July 2024
Accepted after revision: 23 October 2024
Article published online:
22 November 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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