title: Inflammation as a risk factor for atrial fibrillation.
abstract: BACKGROUND
  The presence of systemic inflammation determined by elevations in C-reactive protein (CRP) has been associated with persistence of atrial fibrillation (AF). The relationship between CRP and prediction of AF has not been studied in a large population-based cohort.
  
  
  RESULTS
  CRP measurement and cardiovascular assessment were performed at baseline in 5806 subjects enrolled in the Cardiovascular Health Study. Patients were followed up for a mean of 6.9+/-1.6 (median 7.8) years. AF was identified by self-reported history and ECGs at baseline and by ECGs and hospital discharge diagnoses at follow-up. Univariate and multivariate analyses were used to assess CRP as a predictor of baseline and future development of AF. At baseline, 315 subjects (5%) had AF. Compared with subjects in the first CRP quartile (<0.97 mg/L), subjects in the fourth quartile (>3.41 mg/L) had more AF (7.4% versus 3.7%, adjusted OR 1.8, 95% CI 1.2 to 2.5; P=0.002). Of 5491 subjects without AF at baseline, 897 (16%) developed AF during follow-up. Baseline CRP predicted higher risk for developing future AF (fourth versus first quartile adjusted hazard ratio 1.31, 95% CI 1.08 to 1.58; P=0.005). When treated as a continuous variable, elevated CRP predicted increased risk for developing future AF (adjusted hazard ratio for 1-SD increase, 1.24; 95% CI 1.11 to 1.40; P<0.001).
  
  
  CONCLUSIONS
  CRP is not only associated with the presence of AF but may also predict patients at increased risk for future development of AF.
authors: Department of Cardiovascular Medicine, Desk F15, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, Ohio 44951, USA.
authors: Ronnier J
authors: RJ
authors: Aviles
authors: David O
authors: DO
authors: Martin
authors: Carolyn
authors: C
authors: Apperson-Hansen
authors: Penny L
authors: PL
authors: Houghtaling
authors: Pentti
authors: P
authors: Rautaharju
authors: Richard A
authors: RA
authors: Kronmal
authors: Russell P
authors: RP
authors: Tracy
authors: David R
authors: DR
authors: Van Wagoner
authors: Bruce M
authors: BM
authors: Psaty
authors: Michael S
authors: MS
authors: Lauer
authors: Mina K
authors: MK
authors: Chung
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002097:C-Reactive Protein / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein