title: C reactive protein concentration and recurrence of atrial fibrillation after electrical cardioversion.
abstract: BACKGROUND
  To test the hypothesis that a high C reactive protein (CRP) concentration would predict recurrence of atrial fibrillation (AF) after cardioversion in patients taking antiarrhythmic drugs.
  
  
  METHODS
  111 patients who underwent direct current cardioversion for symptomatic AF were enrolled. Blood was drawn for CRP determination before cardioversion on the same day. All patients were taking antiarrhythmic drugs before and after electrical cardioversion.
  
  
  RESULTS
  After a mean follow up of 76 days, 75 patients had recurrence of AF. In univariate analysis, the median CRP concentration was significantly higher in patients with AF recurrence (3.95 mg/l v 1.81 mg/l, p = 0.002). Among the 55 patients with CRP in the upper 50th centile, 44 (80%) experienced recurrence of AF over a total follow up of 8.98 patient years, whereas among the 56 patients with CRP in the lower 50th centile, 31 (55%) experienced recurrence of AF over a total follow up of 14.3 patient years (p < 0.001). The adjusted hazard ratio comparing the upper 50th centile of CRP with the lower 50th centile of CRP was 2.0 (95% confidence interval 1.2 to 3.2, p = 0.007).
  
  
  CONCLUSIONS
  CRP is independently associated with recurrence of AF after electrical cardioversion among patients taking antiarrhythmic drugs. These results suggest that inflammation may have a role in the pathogenesis of AF resistant to antiarrhythmic drugs.
authors.affiliation: The Center for Atrial Fibrillation, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: O
authors.initials: O
authors.lastname: Wazni
authors.forename: D O
authors.initials: DO
authors.lastname: Martin
authors.forename: N F
authors.initials: NF
authors.lastname: Marrouche
authors.forename: M
authors.initials: M
authors.lastname: Shaaraoui
authors.forename: M K
authors.initials: MK
authors.lastname: Chung
authors.forename: S
authors.initials: S
authors.lastname: Almahameed
authors.forename: R A
authors.initials: RA
authors.lastname: Schweikert
authors.forename: W I
authors.initials: WI
authors.lastname: Saliba
authors.forename: A
authors.initials: A
authors.lastname: Natale
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012008:Recurrence; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein