High sensitivity C-reactive protein: a novel predictor for recurrence of atrial fibrillation after successful cardioversion.
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.
Malouf
Joseph F
JF
Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Kanagala
Ravi
R
Al Atawi
Faisal O
FO
Rosales
A Gabriela
AG
Davison
Diane E
DE
Murali
Narayana S
NS
Tsang
Teresa S M
TS
Chandrasekaran
Krishnaswamy
K
Ammash
Naser M
NM
Friedman
Paul A
PA
Somers
Virend K
VK
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
D002097:C-Reactive Protein