High CRP concentration was associated with increased atrial fibrillation recurrence after electrical cardioversion compared to lower CRP concentration (HR 2.0; 95% CI 1.2-3.2; p=0.007).
Cohort (n=111)
Does a high C reactive protein concentration predict recurrence of atrial fibrillation after electrical cardioversion in patients taking antiarrhythmic drugs?
Elevated baseline CRP levels are independently associated with a higher risk of atrial fibrillation recurrence after electrical cardioversion, suggesting a role for inflammation in drug-resistant AF.
Hazard Ratio: 2 (95% CI 1.2–3.2)
Absolute Event Rate: 80% vs 55%
p-value: p=0.007
BACKGROUND: To test the hypothesis that a high C reactive protein (CRP) concentration would predict recurrence of atrial fibrillation (AF) after cardioversion in patients taking antiarrhythmic drugs. METHODS: 111 patients who underwent direct current cardioversion for symptomatic AF were enrolled. Blood was drawn for CRP determination before cardioversion on the same day. All patients were taking antiarrhythmic drugs before and after electrical cardioversion. RESULTS: After a mean follow up of 76 days, 75 patients had recurrence of AF. In univariate analysis, the median CRP concentration was significantly higher in patients with AF recurrence (3.95 mg/l v 1.81 mg/l, p = 0.002). Among the 55 patients with CRP in the upper 50th centile, 44 (80%) experienced recurrence of AF over a total follow up of 8.98 patient years, whereas among the 56 patients with CRP in the lower 50th centile, 31 (55%) experienced recurrence of AF over a total follow up of 14.3 patient years (p < 0.001). The adjusted hazard ratio comparing the upper 50th centile of CRP with the lower 50th centile of CRP was 2.0 (95% confidence interval 1.2 to 3.2, p = 0.007). CONCLUSIONS: CRP is independently associated with recurrence of AF after electrical cardioversion among patients taking antiarrhythmic drugs. These results suggest that inflammation may have a role in the pathogenesis of AF resistant to antiarrhythmic drugs.
Wazni et al. (Thu,) conducted a cohort in symptomatic atrial fibrillation (n=111). High C reactive protein (CRP) concentration (upper 50th centile) vs. Lower 50th centile of CRP was evaluated on recurrence of atrial fibrillation (HR 2.0, 95% CI 1.2 to 3.2, p=0.007). High CRP concentration was associated with increased atrial fibrillation recurrence after electrical cardioversion compared to lower CRP concentration (HR 2.0; 95% CI 1.2-3.2; p=0.007).
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