Clin Interv Aging. 2026 Jun 12;21:608687. doi: 10.2147/CIA.S608687. eCollection 2026.
ABSTRACT
BACKGROUND: Insulin resistance (IR) plays a significant role in the onset and progression of atrial fibrillation (AF). The single-point insulin sensitivity estimator (SPISE) index is a novel marker for assessing IR. This study aims to investigate the association between the SPISE index and the recurrence of AF following radiofrequency ablation (RFA) in elderly patients.
METHODS: A total of 529 elderly patients (aged 65 and above) with AF who underwent RFA treatment were included in the study. The Cox proportional hazards model was employed to assess the association between the SPISE index and AF recurrence after RFA. Within this framework, a restricted cubic spline (RCS) was used to evaluate the nonlinear relationship between SPISE index and AF recurrence. Kaplan-Meier survival analysis was conducted to compare AF recurrence rates among different groups. Additionally, subgroup analyses were performed to assess the heterogeneity of these effects. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the predictive value of the SPISE index for AF recurrence.
RESULTS: After follow-up, a total of 175 patients (33.1%) experienced recurrence. In the fully adjusted Cox proportional hazards model, SPISE index was significantly associated with AF recurrence (HR = 0.661, P < 0.001). The RCS analysis indicated a negative, nonlinear relationship between the SPISE index and the recurrence of AF. In the subgroups defined by early recurrence, AF type, gender, hypertension, diabetes, and coronary heart disease, the association between the SPISE index and AF recurrence remained consistent. Kaplan-Meier survival analysis revealed significant differences in recurrence rates among patients with varying SPISE index levels. Specifically, a higher SPISE index was associated with a lower cumulative incidence of AF recurrence.
CONCLUSION: A higher SPISE index is associated with a reduced risk of recurrence after RFA in elderly patients with AF.
PMID:42312040 | PMC:PMC13271428 | DOI:10.2147/CIA.S608687