Key result
An apnoea/hypopnoea index ≥15 events/h and hs-CRP >0.30 mg/dL strongly predicted atrial fibrillation recurrence at 1 year (85% with altered variables vs 27% with normal variables).
Why the study?
Do elevated apnoea/hypopnoea index and high-sensitivity C-reactive protein predict atrial fibrillation recurrence after successful electrical cardioversion?
Cohort (n=158)
Do elevated apnoea/hypopnoea index and high-sensitivity C-reactive protein predict atrial fibrillation recurrence after successful electrical cardioversion?
Absolute Event Rate: 85% vs 27%
Elevated apnoea/hypopnoea index and high-sensitivity C-reactive protein are strong independent predictors of atrial fibrillation recurrence within 1 year after successful electrical cardioversion.
May aid post-cardioversion risk stratification; leaves open whether treating OSA or inflammation reduces recurrence.
AIMS: We tested apnoea/hypopnoea index (AHI), high-sensitivity (hs) C-reactive protein and clinical/instrumental variables as predictors of atrial fibrillation (AF) recurrence over 1-year follow-up after successful electrical cardioversion. METHODS AND RESULTS: We enrolled 158 consecutive patients. Apnoea/hypopnoea index was assessed with standard overnight polysomnography and hs-C-reactive protein with immunonephelometry assay the day before electrical cardioversion. Atrial fibrillation recurrences occurred in 81 patients (51%). Predictors at univariate analysis were: AHI > or = 15 events/h (P = 0.001), hs-C-reactive protein >0.30 mg/dL (P = 0.009), AF duration >3 days (P = 0.008), diabetes (P = 0.03), and ongoing anti-arrhythmic therapy at the time of electrical cardioversion (P = 0.03). Survival analysis confirmed that patients with AHI > or = 15 events/h and hs-C-reactive protein > 0.30 mg/dL had a higher recurrence rate of AF (log rank P = 0.0006 and P = 0.01, respectively). Predictors at multivariate analysis were: AHI > or = 15 events/h (P = 0.003), hs-C-reactive protein > 0.30 mg/dL (P = 0.01) and ongoing anti-arrhythmic therapy (P = 0.04). A predictive model based upon the multiple effects of significant variables plus age as a continuous variable stratified the risk of AF recurrence, more than tripled with all dichotomized variables altered with respect to normal variables (85 vs. 27%). CONCLUSION: AHI > or = 15 events/h and hs-C-reactive protein > 0.30 mg/dL are the strongest predictors of the predictors chosen of AF recurrence after successful electrical cardioversion over 1-year follow-up.
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Mazza et al. (2009) conducted a cohort in Atrial fibrillation (n=158). Apnoea/hypopnoea index ≥15 events/h and hs-CRP >0.30 mg/dL vs. Normal variables was evaluated on Atrial fibrillation recurrence. An apnoea/hypopnoea index ≥15 events/h and hs-CRP >0.30 mg/dL strongly predicted atrial fibrillation recurrence at 1 year (85% with altered variables vs 27% with normal variables).
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