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Higher Copeptin Levels are Associated with the Risk of Atrial Fibrillation in Patients with Rheumatic Mitral Stenosis

Authors
  • Avci, Ilhan Ilker1
  • Sahin, Irfan2
  • Gungor, Baris1
  • Kücük, Suat Hayri3
  • Sigirci, Serhat4
  • Varol, Sinan2
  • Tugrul, Sevil2
  • Atici, Adem5
  • İnce, Orhan2
  • Okuyan, Ertugrul2
  • 1 Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital;
  • 2 Department of Cardiology;
  • 3 Department of Biochemistry, Bagcilar Training and Research Hospital;
  • 4 Department of Cardiology, Şişli Hamidiye Etfal Training and Research Hospital;
  • 5 Department of Cardiology, Medeniyet Üniversitesi Göztepe Etfal Training and Research Hospital, Istanbul, Turkey.
Type
Published Article
Journal
Acta Cardiologica Sinica
Publisher
Taiwan Society of Cardiology
Publication Date
Jul 01, 2021
Volume
37
Issue
4
Pages
412–419
Identifiers
DOI: 10.6515/ACS.202107_37(4).20210111A
PMID: 34257491
PMCID: PMC8261697
Source
PubMed Central
Keywords
Disciplines
  • Valvular Heart Disease
License
Unknown

Abstract

Background Correlations between increased copeptin levels and various cardiovascular diseases have been described. In this study, we aimed to investigate the correlation between increased copeptin levels and paroxysmal atrial fibrillation (PAF) in rheumatic mitral stenosis (MS). Methods Patients with mild/moderate rheumatic MS and sinus rhythm were consecutively recruited from an echocardiography laboratory. Patients with a history of PAF and those with PAF on 24-48-hour ambulatory electrocardiography (ECG) monitoring constituted the study group, and those without PAF on ambulatory ECG monitoring constituted the control group. Clinical characteristics, echocardiographic parameters and levels of copeptin, plasma N-terminal proBNP (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) were evaluated. Results Twenty-nine patients with PAF and 124 control MS patients were studied. Patients in the PAF group were older, but the mitral valve areas and transmitral gradients were not different between the groups. In the PAF group, hs-CRP (1.2 vs. 0.8 mg/L, p < 0.001), NT-proBNP (335 vs. 115 pg/mL, p < 0.001) and copeptin (6.9 vs. 4.0 pmol/L, p < 0.001) levels were significantly higher than in the control group. Multivariable logistic regression analysis revealed that age [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.04-1.38; p = 0.024], left atrial volume index (OR 1.23, 95% CI 1.06-1.41; p = 0.032), copeptin levels (OR 2.81, 95% CI 1.30-5.29; p < 0.001) and hs-CRP levels (OR 15.5, 95% CI 1.41-71.5; p = 0.012) were independent predictors of PAF. Conclusions In patients with mild/moderate rheumatic MS, higher copeptin and hs-CRP levels predicted a higher risk of developing atrial fibrillation.

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