Soluble ST2 biomarker utility in the comprehension of the clinical course of atrial fibrillation

Abstract Background Atrial fibrillation (AF) is the more frequent arrhythmia in clinical practice and probably one of the more analyzed. Despite this, the clinical pattern classification not always correlates with the clinical course of AF. There are still a lack of biomarkers to predict recurrence and the clinical course of this disease. Purpose ST2 soluble (ST2S) biomarker has being previously analyzed by our group in patients with AF and electrical cardioversion (ECV) demonstrating utility to predict recurrence. We sought to analyze the clinical outcome of patients with AF who underwent an ECV or pulmonary vein isolation (PVI) and its correlation with the ST2S biomarker at mid-term follow-up. Methods We performed a prospective, observational clinical trial that included 250 patients with AF who were referred to our hospital for a clinical procedure including ECV or PVI from September 2016 to 2019. A total of 40 matched controlled patients were also included for the initial analysis. ST2S was analyzed from blood samples at baseline, 3- and 6-months follow-up. Results From 250 patients with AF: 94 underwent an ECV and 156 patients an PVI. Mean age was of 58.5 ±10.4 years. From the 156 PVI: 68 had paroxysmal and 88 persistent AF. Clinical follow-up was continued for 1 year and recurrence was of 65.9% in ECV and 22.4% in PVI patients. Clinical and echocardiographic characteristic are described in table1. The initial value of the ST2S biomarker was higher in AF cases with respect to controls (p