Inflammation as a risk factor for atrial fibrillation.
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.
Aviles
Ronnier J
RJ
Department of Cardiovascular Medicine, Desk F15, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, Ohio 44951, USA.
Martin
David O
DO
Apperson-Hansen
Carolyn
C
Houghtaling
Penny L
PL
Rautaharju
Pentti
P
Kronmal
Richard A
RA
Tracy
Russell P
RP
Van Wagoner
David R
DR
Psaty
Bruce M
BM
Lauer
Michael S
MS
Chung
Mina K
MK
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
D002097:C-Reactive Protein