Clinical Report: Insulin Resistance and Cardiovascular Risk in AF Patients Post-Ablation

Overview

This study evaluates the association between non-insulin-based insulin resistance indices and long-term major adverse cardiovascular events (MACEs) in atrial fibrillation (AF) patients after radiofrequency catheter ablation (RFCA). METS-IR and TyG-BMI were found to significantly predict elevated MACE risk.

Background

Atrial fibrillation (AF) is a prevalent arrhythmia that significantly increases the risk of stroke, heart failure, and mortality. Catheter ablation is a first-line treatment for AF, yet many patients experience adverse cardiovascular events post-procedure. Understanding the role of insulin resistance in predicting these outcomes is crucial for improving risk stratification and patient management.

Data Highlights

Key Findings

• METS-IR and TyG-BMI were independently associated with elevated MACE risk (P < 0.001).
• The TG/HDL-C ratio and TyG index did not reach statistical significance in fully adjusted models.
• METS-IR showed a linear dose-response relationship with MACEs.
• Inclusion of METS-IR improved the C-statistic from 0.702 to 0.717 (P < 0.001).
• The study included 922 non-valvular AF patients undergoing RFCA.
• MACEs were defined as all-cause death, late AF recurrence, heart failure events, and stroke.

Clinical Implications

The findings indicate that METS-IR may improve the prediction of adverse outcomes in AF patients post-ablation.

Conclusion

METS-IR demonstrates a modest but significant improvement in predicting long-term MACEs in AF patients following RFCA.

Related Resources & Content

1. Luo et al., Frontiers in Cardiovascular Medicine, 2026 -- A study on risk factors of acute ischemic stroke after radiofrequency ablation in patients with atrial fibrillation
2. Luo et al., Frontiers in Cardiovascular Medicine, 2026 -- Systemic immune-inflammation Index and blood pressure control are independent and interactive predictors of atrial fibrillation recurrence after ablation
3. Post-Ablation Sinus Heart Rate and Long-Term Recurrence Risks in Patients with Atrial Fibrillation, Clinical Research in Cardiology, 2020
4. Long-term outcome of patients with atrial fibrillation and heart failure with preserved ejection fraction after combined radiofrequency catheter ablation and left atrial appendage closure, Frontiers in Cardiovascular Medicine, 2026
5. 2024 Atrial Fibrillation Guidelines, European Society of Cardiology
6. 2024 Atrial Fibrillation
7. https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-024-02158-6.pdf