What is the clinical evidence from this study?

Study design: Case-Control. Population: Paroxysmal Atrial Fibrillation (n=103). Intervention: Paroxysmal Atrial Fibrillation vs. Healthy controls. Primary outcome: Baseline plasma concentration of hs-CRP (mg/L) (p=0.003).

What question did this study set out to answer?

The study aims to measure inflammatory markers in patients with paroxysmal atrial fibrillation and their dynamics over time.

January 1, 2016Cardiology ResearchOpen Access

Significant Increase in C-Reactive Protein and Serum Amyloid A in the Early Hours of Paroxysmal Atrial Fibrillation

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Key result

Paroxysmal atrial fibrillation was associated with significantly higher baseline plasma concentrations of hs-CRP (8.12 vs. 5.57 mg/L) and SAA (16.04 vs. 5.12 ng/mL) compared to healthy controls.

Why the study?

Does paroxysmal atrial fibrillation cause an acute increase in inflammatory biomarkers (hs-CRP, SAA, fibrinogen) compared to healthy controls?

Population

103 participants. Mean age ~59.8 years, ~50% male. Excluded: cardiovascular diseases…

Comparison

Paroxysmal atrial fibrillation episode treated… vs Healthy volunteers without a history or…

Design

Cohort

Follow-up

28 days

Authors

МNМariya NegrevaMedical University of Varna SGSvetoslav GeorgievUniversity Hospital St. Marina KPKrasimira ProdanovaTechnical University of Sofia

Discussion

Member takes

Implication

Inflammation markers may associate with paroxysmal AF; hypothesis-generating and should not yet change practice.

Key Points

The study aims to measure inflammatory markers in patients with paroxysmal atrial fibrillation and their dynamics over time.
Measured hs-CRP, SAA, and fibrinogen in 51 patients at baseline, 24 hours, and 28 days after rhythm restoration.
Compared these markers with 52 controls during the same time points.
Hs-CRP concentration was significantly higher in patients (8.12 mg/L vs. 5.57 mg/L, P=0.003).
SAA was also elevated in patients (16.04 ng/mL vs. 5.12 ng/mL, P<0.001) and remained high 24 hours post-restoration.
No significant difference in fibrinogen levels was observed between patients and controls throughout the study.

Study Design

Type

Case-Control (n=103)

Multicenter

Structured PICO

Does paroxysmal atrial fibrillation cause an acute increase in inflammatory biomarkers (hs-CRP, SAA, fibrinogen) compared to healthy controls?

Population

103 participants, including 51 patients with paroxysmal atrial fibrillation and 52 healthy controls, with a mean age of 60 years, followed for 28 days after sinus rhythm restoration.

Exposure

Paroxysmal atrial fibrillation episode treated with propafenone (IV 2 mg/kg bolus, then infusion at 0.0078 mg/kg/min for 120 min, then oral 300 mg three times at 8 h intervals, followed by maintenance oral 150 mg three times daily) for sinus rhythm restoration.

Comparator

Healthy volunteers without a history or electrocardiographic evidence of atrial fibrillation.

Outcome

Plasma concentrations of high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), and fibrinogen at hospital admission (baseline), 24 hours, and 28 days after sinus rhythm restoration.surrogate

Main Result

Absolute Event Rate: 8.12% vs 5.57%

p-value: p=0.003

Paroxysmal atrial fibrillation is associated with an acute, transient inflammatory response characterized by elevated hs-CRP and SAA in the early hours of the arrhythmia, which normalizes by 28 days after sinus rhythm restoration.

Limitations

Small sample size
Observational design cannot definitively establish whether the inflammatory response precedes the rhythm disorder or is a consequence of it
Study design does not allow for a definitive answer on whether the inflammatory response precedes the manifestation of the rhythm disorder or is a consequence of it.

Cite This Study

Negreva et al. (2016) conducted a case-control in Paroxysmal Atrial Fibrillation (n=103). Paroxysmal Atrial Fibrillation vs. Healthy controls was evaluated on Baseline plasma concentration of hs-CRP (mg/L) (p=0.003). Paroxysmal atrial fibrillation was associated with significantly higher baseline plasma concentrations of hs-CRP (8.12 vs. 5.57 mg/L) and SAA (16.04 vs. 5.12 ng/mL) compared to healthy controls.

synapsesocial.com/papers/6a7bcf681f8f1eb7b8ed34bd https://doi.org/10.14740/cr455w

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Significant Increase in C-Reactive Protein and Serum Amyloid A in the Early Hours of Paroxysmal Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Significant Increase in C-Reactive Protein and Serum Amyloid A in the Early Hours of Paroxysmal Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider