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. 2009 Jul 30;32(9):E45–E50. doi: 10.1002/clc.20430

C–Reactive Protein and Atrial Fibrillation in Idiopathic Dilated Cardiomyopathy

Dai, Shimo 1, Zhang Shu 1,✉, Guo Ying hua 1, Jianmin Chu 1, Wei Hua 1, Fang zheng Wang 1
PMCID: PMC6653353  PMID: 19645035

Abstract

Background

Previous studies have found elevated plasma C‐reactive protein (CRP) levels in atrial fibrillation (AF) patients. Most of these studies included AF patients with various heart diseases, but few studies were designed to investigate CRP in idiopathic dilated cardiomyopathy (IDCM) patients with AF.

Method and Results

CRP levels in 242 IDCM patients with AF were compared with CRP levels in 280 control IDCM patients. Among control patients, 70 had atrial premature beats or atrial tachycardia and 210 had normal sinus rhythm. CRP was higher in the AF group than in the control group (median, 4.59 versus 2.81 mg/L; p < 0.001). The prevalence of AF in IDCM patients increased as plasma CRP levels increased, and the patients with the highest plasma CRP levels had the highest probability of suffering from AF. Outcome of multivariate logistic regression analysis showed body mass index, AF, and white blood cell count significantly correlated with the plasma CRP levels.

Conclusion

Our data demonstrated that the plasma CRP level in IDCM patients with AF was higher than in IDCM patients without AF, and an increase in plasma CRP levels was associated with an increased prevalence of AF in IDCM patients. Also, body mass index, AF, and white blood cell count correlate with plasma CRP levels in IDCM patients. These data suggest there is presence of inflammation in IDCM patients with AF. Copyright © 2009 Wiley Periodicals, Inc.

Full Text

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References

  • 1. Chung MK, Martin DO, Sprecher D, 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, Hansen CA, 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, 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, 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. Carnes CA, Chung MK, Nakayama T, 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): 32–38. [DOI] [PubMed] [Google Scholar]
  • 8. Frustaci A, Chimenti C, Bellocci F, et al. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 1997; 96(4): 1180–1184. [DOI] [PubMed] [Google Scholar]
  • 9. Kaneko K, Kanda T, Yamauchi Y, et al. C‐reactive protein in dilated cardiomyopathy. Cardiology 1999; 91: 215–219. [DOI] [PubMed] [Google Scholar]
  • 10. Alonso‐Martínez JL, Llorente‐Dieza B, Echegaray‐Agara M, et al. C‐reactive protein as a predictor of improvement and readmission in heart failure. Eur J Heart Fail 2002; 4(7): 331–336. [DOI] [PubMed] [Google Scholar]
  • 11. Ishikawa C, Tsutamoto T, Fujii M, et al. Prediction of mortality by high‐sensitivity c‐reactive protein and brain natriuretic peptide in patients with dilated cardiomyopathy. Circ J 2006; 70: 857–863. [DOI] [PubMed] [Google Scholar]
  • 12. Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM. Increased adipose tissue expression of tumor necrosis factor‐alpha in human obesity and insulin resistance. J Clin Invest 1995; 95(5): 2409–2415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13. Hutley L, Prins JB. Fat as an endocrine organ: Relationship to the metabolic syndrome. Am J Med Sci 2005; 330(6): 280–289. [DOI] [PubMed] [Google Scholar]
  • 14. Kolb H, Mandrup‐Poulsen T. An immune origin of type 2 diabetes? Diabetologia 2005; 48(6): 1038–1050. [DOI] [PubMed] [Google Scholar]
  • 15. Weisberg SP, McCan D, Desai M, et al. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 2003; 112(2): 1796–1808. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16. Xu H, Barnes GT, Yang Q. Chronic inflammation in fat plays a critical role in the development of obesity related insulin resistance. J Clin Invest 2003; 112(12): 1821–1830. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17. Acevedo M, Corbalán R, Braun S, et al. C‐reactive protein and atrial fibrillation: “Evidence for the presence of inflammation in the perpetuation of the arrhythmia.” Int J Cardiol 2006; 108(3): 326–331. [DOI] [PubMed] [Google Scholar]
  • 18. Malouf JF, Kanagala R, Al Atawi FO, et al. High sensitivity C‐reactive protein: A novel predictor for recurrence of atrial fibrillation after successful cardioversion. J Am Coll Cardiol 2005; 46(7): 1284–1287. [DOI] [PubMed] [Google Scholar]
  • 19. Loricchio ML, Cianfrocca C, Pasceri V, et al. Relation of C‐reactive protein to long‐term risk of recurrence of atrial fibrillation after electrical cardioversion. Am J Cardiol 2007; 99(10): 1421–1424. [DOI] [PubMed] [Google Scholar]
  • 20. Patrick TE, Adrian L, Kristen KP, Marisa AS, Calum AM. C‐reactive protein in lone atrial fibrillation. Am J Cardiol 2006; 97(9): 1346–1350. [DOI] [PubMed] [Google Scholar]
  • 21. Guerra PG, Lesh MD. The role of nonpharmacologic therapies for the treatment of atrial fibrillation. J Cardiovasc Electrophysiol 1999; 10: 450–460. [DOI] [PubMed] [Google Scholar]
  • 22. Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998; 339: 659–666. [DOI] [PubMed] [Google Scholar]

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