Abstract
Objectives
This study was designed to evaluate the correlation between lone atrial fibrillation and inflammation.
Methods
A total of 411 subjects were enrolled in this study, including 333 patients with lone atrial fibrillation, and 78 controls. C‐reactive protein (CRP) and echocardiography were evaluated, and the electrocardiograph was monitored to identify cardiac rhythm at the time of blood sampling. According to the rhythm, paroxysmal atrial fibrillation was divided into presence and absence of atrial fibrillation.
Results
Subjects with lone atrial fibrillation had higher CRP levels than controls (media, 1.00 mg/L; IQR, 1.00–2.54 versus media, 1.00 mg/L; IQR, 1.00–1.55; p = 0.016) and subjects with persistent atrial fibrillation had higher CRP levels than those with paroxysmal atrial fibrillation (media, 1.62 mg/L; IQR, 1.00–3.98 versus media, 1.00 mg/L, IQR, 1.00–2.10; p = 0.022), and so did presence of atrial fibrillation rather than absence of atrial fibrillation (media, 2.11 mg/L; IQR, 1.00–3.60 versus media, 1.00 mg/L; IQR, 1.00–1.76; p = 0.000) in paroxysmal atrial fibrillation. However, there was no significant difference in CRP levels between persistent atrial fibrillation and presence of atrial fibrillation in paroxysmal atrial fibrillation (p = 0.992). Neither was there any difference between absence of atrial fibrillation in paroxysmal atrial fibrillation and controls (p = 0.483). In patients with lone atrial fibrillation, atrial fibrillation rhythm (B = 4.85, 95%CI: 2.61–8.99) was the only independent predictor of elevated CRP levels after adjusted covariants.
Conclusions
Patients with lone atrial fibrillation had elevated CRP levels only when they were in atrial fibrillation rhythm and an elevated CRP level was not related to duration of time or history of atrial fibrillation. Copyright © 2009 Wiley Periodicals, Inc.
Keywords: atrial fibrillation, inflammation, C‐reactive protein
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References
- 1. Chung MK, Martin DO, Sprecher D, Wazni D, Kanderian A, et al.: C‐reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104(24): 2886–2891. [DOI] [PubMed] [Google Scholar]
- 2. Aviles RJ, Martin DO, Apperson‐Hansen C, Houghtaling Pl, Qautaharju P, et al.: Inflammation as a risk factor for atrial fibrillation. Circulation 2003; 108(24): 3006–3010. [DOI] [PubMed] [Google Scholar]
- 3. Ishii Y, Schuessler RB, Gaynor SL, Yamada K, Fu AS, et al.: Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation 2005; 111(22): 2881–2888. [DOI] [PubMed] [Google Scholar]
- 4. Kumagai K, Nakashima H, Saku K. The HMG‐CoA reductase inhibitor atorvastatin prevents atrial fibrillation by inhibiting inflammation in a canine sterile pericarditis model. Cardiovasc Res 2004; 62(1): 105–111. [DOI] [PubMed] [Google Scholar]
- 5. Bruins P, te Velthuis H, Yazdanbakhsh AP, Jansen PG, van Hardevelt FW, et al.: Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C‐reactive protein and is associated with postoperative arrhythmia. Circulation 1997; 96(10): 3542–3548. [DOI] [PubMed] [Google Scholar]
- 6. Watanabe E, Arakawa T, Uchiyama T, Kodama I, Hishida H. High‐sensitivity C‐reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion. Int J Cardiol 2006; 108(3): 346–353. [DOI] [PubMed] [Google Scholar]
- 7. Frustaci A, Chimenti C, Bellocci F, Morqante E, Russo MA, et al.: Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 1997; 96(4): 1180–1184. [DOI] [PubMed] [Google Scholar]
- 8. Carnes CA, Chung MK, Nakayama T, Nakayama T, Nakayama H, et al.: Ascorbate attenuates atrial pacing‐induced peroxynitrite formation and electrical remodeling and decreases the incidence of postoperative atrial fibrillation. Circ Res 2001; 89(6): E32–E38. [DOI] [PubMed] [Google Scholar]
- 9. Zoccali C, Maio R, Tripepi G, Mallamaci F, Perticone F: Inflammation as a mediator of the link between mild to moderate renal insufficiency and endothelial dysfunction in essential hypertension. J Am Soc Nephrol 2006; 17(4): S64–S68. [DOI] [PubMed] [Google Scholar]
- 10. Luft FC. Angiotensin, inflammatory, hypertension, and cardiovascular disease. Curr Hypertens Rep 2001; 3(1): 61–67. [DOI] [PubMed] [Google Scholar]
- 11. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336(14): 973–979. [DOI] [PubMed] [Google Scholar]
- 12. Sunq KC, Suh JY, Kim BS, Kang JH, Kim H, et al.: High sensitivity C‐reactive protein as an independent risk factor for essential hypertension. Am J Hypertens 2003; 16(6): 429–433. [DOI] [PubMed] [Google Scholar]
- 13. Saito M, Ishimitsu T, Minami J, Ono H, Ohrui M, et al.: Relations of plasma high‐sensitivity C‐reactive protein to traditional cardiovascular risk factors. Therosclerosis 2003; 167(1): 73–79. [DOI] [PubMed] [Google Scholar]
- 14. Conway DS, Buggins P, Hughes E, Lip GY: Relationship of interleukin‐6 and C‐reactive protein to the prothrombotic state in chronic atrial fibrillation. J Am Coll Cardiol 2004; 43(11): 2075–2082. [DOI] [PubMed] [Google Scholar]
- 15. Ellinor PT, Low A, Patton KK, Shea MA, Macrae CA: C‐reactive protein in lone atrial fibrillation. Am J Cardiol 2006; 97(9): 1346–1350. [DOI] [PubMed] [Google Scholar]
- 16. Hatzinikolaou‐Kotsakou E, Tziakas D, Hotidis A, Stakos D, Floros D, et al.: Relation of C‐reactive protein to the first onset and the recurrence rate in lone atrial fibrillation. Am J Cardiol 2006; 97(5): 659–661. [DOI] [PubMed] [Google Scholar]