title: High sensitivity C-reactive protein: a novel predictor for recurrence of atrial fibrillation after successful cardioversion.
abstract: OBJECTIVE
  We sought to test the hypothesis that C-reactive protein (CRP) can predict the recurrence of atrial fibrillation (AF) after successful electrical cardioversion (CV).
  
  
  BACKGROUND
  In patients with AF, CRP levels are predictive of immediate failure of CV.
  
  
  METHODS
  We prospectively measured high-sensitivity CRP in 67 patients with AF or atrial flutter who underwent successful electrical CV.
  
  
  RESULTS
  At one-month follow-up, 22 patients (33%) had recurrence of their arrhythmia. Arrhythmia recurrence was associated with significantly higher pre-CV CRP levels (odds ratio [OR] 1.84; 95% confidence interval [CI] 1.14 to 2.98; p = 0.013) even after adjusting for age (OR 2.22; 95% CI 1.25 to 3.93; p = 0.006), for gender (OR 1.89; 95% CI 1.16 to 3.09; p = 0.011), or duration of arrhythmia (OR 1.86; 95% CI 1.13 to 3.07; p = 0.015). On multivariate analysis, CRP was the only independent predictor of arrhythmia recurrence (OR 2.19; 95% CI 1.05 to 4.55; p = 0.036).
  
  
  CONCLUSIONS
  Our data suggest that high levels of CRP are associated with an increased risk of recurrence of AF within one month. These data support the hypothesis that anti-inflammatory interventions may help in maintenance of normal sinus rhythm after CV. These data also may have implications for the identification of patients who are most likely to experience substantial benefit from CV therapy for AF.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Malouf
authors.forename: Ravi
authors.initials: R
authors.lastname: Kanagala
authors.forename: Faisal O
authors.initials: FO
authors.lastname: Al Atawi
authors.forename: A Gabriela
authors.initials: AG
authors.lastname: Rosales
authors.forename: Diane E
authors.initials: DE
authors.lastname: Davison
authors.forename: Narayana S
authors.initials: NS
authors.lastname: Murali
authors.forename: Teresa S M
authors.initials: TS
authors.lastname: Tsang
authors.forename: Krishnaswamy
authors.initials: K
authors.lastname: Chandrasekaran
authors.forename: Naser M
authors.initials: NM
authors.lastname: Ammash
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis*; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction
chemical_list: D002097:C-Reactive Protein