Key result
Metabolic syndrome in patients with atrial fibrillation was associated with higher C-reactive protein levels (4.43 vs 2.33 mg/L, p<0.0001) compared to patients with AF without MS.
Why the study?
The study aimed to determine the blood level of inflammatory markers, parameters characterizing obesity, and cardiac remodeling in patients with AF combined with metabolic syndrome.
Case-Control (n=677)
Absolute Event Rate: 4.43% vs 2.33%
p-value: p=<0.0001
Elevated pro-inflammatory biomarkers are associated with cardiac remodeling and increased epicardial fat thickness in patients with metabolic syndrome and atrial fibrillation.
Associated inflammatory marker elevations in AF with metabolic syndrome should not change practice; leaves open causal role in remodeling.
Aim. To determine the blood level of inflammatory markers, parameters characterizing obesity and cardiac remodeling in patients with atrial fibrillation (AF) in combination with metabolic syndrome (MS). Material and methods. This single-stage case-control study included 677 subjects aged 35 to 65 years: patients with MS (n=407), of which 128 patients with AF; comparison group — patients with AF without MS (n=75); control group — practically healthy subjects without cardiovascular diseases and metabolic disorders (n=195). Results. It was found that the blood concentration of circulating pro-inflammatory biomarkers in patients with AF and MS is higher than in patients with AF without MS: C-reactive protein (CRP) (4,43 (2,68-4,98) and 2,33 (1,08-4,7) mg/L, p<0,0001), interleukin-6 (IL-6) (2,5 (1,28-5,13) and 1,27 (0,68-2,7) pg/ml, p<0,0001) and tumor necrosis factor-α (TNF-α) (5,18 (2,63-7,32) and 3,42 (2,115,48) pg/ml, p<0,0001). The serum CRP concentration positively correlates with left (ρ=0,451, p<0,0001) and right atrial (ρ=0,412, p<0,000) volumes, as well as with the waist circumference (ρ=0,503, p<0,001) and epicardial fat thickness (ρ=0,550, p<0,001). Plasma IL-6 and serum TNF-α levels correlated to a lesser extent with parameters characterizing atrial remodeling, but had a strong positive relationship with epicardial fat thickness. According to multivariate analysis, it was found that an increase in the epicardial fat thickness had a greater effect on an increase in blood concentration of CRP, IL-6 and TNF-α, in contrast to other parameters characterizing obesity, such as body mass index and waist circumference. Conclusion. An increase in the blood concentration of proinflammatory biomarkers CRP, IL-6, and TNF-α is associated with cardiac remodeling and epicardial fat thickness in patients with MS and probably has a pathogenetic role in increasing the AF risk in this cohort of patients.
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Ионин et al. (2021) conducted a case-control in Atrial fibrillation and metabolic syndrome (n=677). Metabolic syndrome vs. AF without MS was evaluated on Blood concentration of C-reactive protein (CRP) (p=<0.0001). Metabolic syndrome in patients with atrial fibrillation was associated with higher C-reactive protein levels (4.43 vs 2.33 mg/L, p<0.0001) compared to patients with AF without MS.
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