Key result
Baseline C-reactive protein levels in the upper two tertiles independently predicted a higher risk of atrial fibrillation recurrence over 3 years.
Why the study?
Do baseline CRP levels predict the long-term risk of atrial fibrillation recurrence after successful electrical cardioversion in patients receiving amiodarone?
Observational (n=60)
Do baseline CRP levels predict the long-term risk of atrial fibrillation recurrence after successful electrical cardioversion in patients receiving amiodarone?
Elevated baseline CRP levels before electrical cardioversion independently predict a significantly higher long-term risk of atrial fibrillation recurrence despite amiodarone therapy.
Answers are grounded in this paper and cite their sources.
May refine post-cardioversion recurrence risk stratification on amiodarone; leaves open whether CRP-guided interventions improve outcomes.
BACKGROUND: An increasing body of evidence links atrial fibrillation (AF) to the inflammatory state. It has been suggested that increased C-reactive protein (CRP) levels are associated with greater risk of AF recurrence at short- and mid-term. OBJECTIVE: We sought to investigate the association between CRP and long-term risk of AF recurrence. METHODS: This was a prospective observational study. We investigated the association between baseline CRP levels and recurrence of AF over a 3-year follow-up period after successful electrical cardioversion (EC). A total of 60 patients were studied (mean age: 68.4 +/- 7.2 years, 60% men). All patients were receiving amiodarone for sinus rhythm maintenance. We further divided the study population into three tertiles according to the values of baseline CRP (tertile 1: <0.43 mg/dL; tertile 2: 0.43-0.8 mg/dL; tertile 3: >0.8 mg/dL). RESULTS: Overall, 75% of patients relapsed into AF during the 3-year study period. AF recurrence was significantly lower in the 1st CRP tertile group (P = 0.039). The Kaplan-Meier survival analysis showed that the rate of AF recurrence was significantly lower in the lowest CRP tertile (log rank; P < 0.001). In a multivariable Cox regression model adjusted for other potential covariates, only CRP (upper two tertiles) was an independent predictor of AF recurrence (heart rate: 6.3, 95% confidence interval: 3.1-12.7, P < 0.001). CONCLUSIONS: Our findings suggest that baseline CRP levels before EC have an independent prognostic value in predicting the long-term risk of AF recurrence.
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Korantzopoulos et al. (2008) conducted an observational in Atrial fibrillation (n=60). Baseline C-reactive protein (upper two tertiles >0.43 mg/dL) vs. Lowest CRP tertile (<0.43 mg/dL) was evaluated on Recurrence of atrial fibrillation (HR 6.3, 95% CI 3.1-12.7, p=<0.001). Baseline C-reactive protein levels in the upper two tertiles independently predicted a higher risk of atrial fibrillation recurrence over 3 years.
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