Oxidative stress markers are associated with persistent atrial fibrillation.
BACKGROUND
Atrial fibrillation (AF) has been associated with myocardial oxidative stress, and antioxidant agents have demonstrated antiarrhythmic benefit in humans. We compared serum markers of oxidation and associated inflammation in individuals with or without AF.


METHODS
Serum markers of oxidative stress and inflammation were compared in a cross-sectional, case-control design study of 40 male individuals, with or without persistent or permanent AF, who were matched for age, sex, diabetes, and smoking status, known confounding variables for the measurement of oxidative stress. We used derivatives of reactive oxidative metabolites (DROMs) and ratios of oxidized to reduced glutathione (E(h) GSH) and cysteine (E(h) CySH) to quantify oxidative stress. We also measured inflammatory markers, including high-sensitivity C-reactive protein, interleukins 1beta and 6, and tumor necrosis factor alpha.


RESULTS
Univariate, conditional logistical regression analysis showed that oxidative stress but not inflammatory markers were statistically associated with AF (P <0.05). The increase in the odds ratios for AF for E(h) GSH, E(h) CySH, and DROMs were 6.1 (95% CI, 1.3-28.3; P = 0.02), 13.6 (95% CI, 2.5-74.1; P = 0.01), and 15.9 (95% CI, 1.7-153.9; P = 0.02), respectively. There was a stronger correlation between E(h) GSH and E(h) CySH (r = 0.66) than between E(h) GSH and DROMs (r = 0.41). In multivariate analysis corrected for statins and other AF risk factors differing between the groups, the association of AF and oxidative stress remained significant.


CONCLUSIONS
These data suggest that oxidative stress markers may have predictive value in AF management.
Neuman
Robert B
RB
Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Bloom
Heather L
HL
Shukrullah
Irfan
I
Darrow
Lyndsey A
LA
Kleinbaum
David
D
Jones
Dean P
DP
Dudley
Samuel C
SC
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003545:Cysteine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005978:Glutathione / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000378:metabolism; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018384:Oxidative Stress; D012044:Regression Analysis; D012907:Smoking; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D005978:Glutathione; D003545:Cysteine