157
￭ S-235 ￭
Atrial Fibrillation After Successful Radiofrequency Catheter Ablation of Typical Atrial Flutter
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
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Moo-Nyun Jin, Jae-Sun Uhm, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
Background: Subsequent development of atrial fibrillation (AF) is common after radiofrequency catheter ablation of typical atrial flutter (AFL);
however, the risk factors of AF after successful AFL ablation have yet to be clearly established. This study investigates the prevalence of and risk factors for AF after successful AFL ablation. Methods: A total of 293 consecutive patients (236 men, mean age 56±14 years) without valvular heart disease who underwent radiofrequency catheter ablation of typical AFL were enrolled in the study. Results: AF was observed in 136 (46%) before ablation. During a follow-up of 40±37 months (1-199 months) 103 (35%) patients had AF after ablation including 37 (13%) newly diagnosed with AF. The patients with postablation AF had higher proportion of male sex (87% vs. 77%, p=0.003), had a larger LA diameter (43±6 vs. 41±6, p=0.03), and had AF before AFL ablation (65% vs. 36%, p<0.001) more frequently than those without postablation AF. In multivariate logistic regression analysis, male sex (OR 2.45, 95% CI 1.02-5.89, p=0.045) and AF before AFL ablation (OR 3.62, 95%
CI 2.03-6.46, p<0.001) were significantly associated with the development of AF after AFL ablation. Conclusions: Patients with typical AFL undergoing successful ablation remain at an elevated risk for AF occurrence. Hypertrophic cardiomyopathy, AF before AFL ablation and male sex were independent risk factors of AF development after AFL ablation.
￭ S-236 ￭
Hemoglobin A1c is associated with arterial stiffness in non-hypertensive Koreans
1경북대학교 의학전문대학원 내과학교실 순환기내과, 2경북대학교 의학전문대학원 내과학교실 내분비내과
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김창연
1, 김남균
1, 김재희
1, 장세용
1, 박선희
1, 배명환
1, 이장훈
1, 양동헌
1, 박헌식
1, 조용근
1, 채성철
1, 김정국
2, 이인규
2Background: It has been known that arterial stiffness [brachial-ankle pulse wave velocity (baPWV)] is associated with hemoglobin A1c (HbA1c) in diabetic hypertensive subjects. However, limited data is available whether glycemic control per se is associated with arterial stiffness independently of blood pressure (BP) in non-hypertensive individuals. Methods: Study subjects were 1,474 Koreans in a rural area in Daegu city.
They were enrolled from August to November 2008 for a cohort study. Of these subjects, 708 non-hypertensive subjects (276 men; mean age=60.5±10.8 years-old) were finally analyzed in this study. The baPWV was measured in the supine position after 5 min of bed rest using an automatic waveform analyzer (Colin VP-1000). Results: The baPWV was significantly higher in diabetes group (HbA1c ≥6.5%, n=76) compared with normal (HbA1c <5.7%, n=248) and pre-diabetes group (5.7%≤ HbA1c ≥6.4%, n=384) (1646.0±359.9 cm/s versus 1480.1±288.9 cm/s versus 1421.5±244.4 cm/s, p for trend <0.001). The HbA1c levels were significantly correlated with baPWV (r=0.229, p<0.001) as well as systolic BP (r=0.422, p<0.001). In multivariate linear regression analysis, HbA1C was independently related to baPWV (beta=0.013, p <0.001) in addition to systolic BP (beta=0.002, p<0.001) after adjusting for confounding variables including systolic BP. The HbA1c is significantly higher in subjects with baPWV ≥median value (6.1% versus 5.8%, p<0.001). In multivariate logistic regression model, HbA1c (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.28-2.59; p=0.001) in addition to age (OR 1.12, 95% CI 1.10-1.14; p<0.001), systolic BP (OR 1.08, 95% CI 1.06-1.10; p<0.001), body mass index (OR 0.83, 95% CI 0.77-0.90; p<0.001), log-transformed high sensitivity C- reactive protein (OR 3.15, 95%
CI 1.62-6.13; p=0.001), log-transformed triglyceride (OR 4.05, 95% CI 1.65-9.92; p=0.002) was an independent predictor of baPWV ≥median value after adjusting for confounding variables. Conclusions: The HbA1c is independently associated with baPWV, and this suggests importance of glycemic control in the prevention of arterial stiffness even in non-hypertensive subjects.
