Serum Uric Acid‐to‐Creatinine Ratio and Atherogenic Index of Plasma as Independent Prognostic Indicators for Late Non‐Valvular Atrial Fibrillation Recurrence After Catheter Ablation

BACKGROUND: Atrial fibrillation (AF) is one of the most common clinical arrhythmias, and postoperative recurrence remains a major concern in cardiovascular medicine. However, the predictive value of atherogenic index of plasma (AIP) and serum uric acid to creatinine ratio (sUA/CrR) for late non-valvular AF recurrence after catheter ablation remains unclear. AIMS: This study aimed to investigate the predictive value of AIP and sUA/CrR for late non-valvular AF recurrence after catheter ablation. METHODS: This study included 401 patients with non-valvular AF who were treated at Fujian Medical University Union Hospital between 2018 and 2022. The associations between the sUA/CrR, AIP, and late AF recurrence after catheter ablation were analyzed using univariate and multivariate Cox regression models, as well as Kaplan-Meier survival analysis. Machine learning methods were used to evaluate the predictive performance of the model. SHapley Additive exPlanations (SHAP) was employed to assess the interpretability of the model. In addition, the potential mediating roles of AIP and sUA/CrR in clinical outcomes were explored. RESULTS: Multivariable Cox regression analysis showed that both the AIP (p = 0.006, HR = 3.259, 95% CI: 1.415-7.506) and the sUA/CrR (p = 0.001, HR = 1.188, 95% CI: 1.069-1.321) were independently associated with late AF recurrence after catheter ablation. Mediation analysis revealed a bidirectional mediating effect between AIP and sUA/CrR in their associations with late AF recurrence. SHAP analysis highlighted that both AIP and sUA/CrR are important predictive indicators for AF recurrence after ablation. CONCLUSION: Both AIP and sUA/CrR are positively correlated with late AF recurrence after catheter ablation, exhibiting a bidirectional mediating effect. A clinical prediction model integrating these two indicators may facilitate risk stratification of late AF recurrence after catheter ablation.