title: Relation of C-reactive protein and new-onset atrial fibrillation in patients with acute myocardial infarction.
abstract: Recent studies have implicated systemic inflammation in the genesis and maintenance of atrial fibrillation (AF). A robust inflammatory response is an integral component of the response to tissue injury during acute myocardial infarction (AMI). However, there is no information concerning the association between inflammation and AF in patients with AMI. We studied 1,209 patients admitted for AMI. C-reactive protein (CRP) was measured by a high-sensitivity assay within 12 to 24 hours after symptom onset. The relation between CRP and new-onset AF occurring during the hospital course and at 1 year was analyzed using multivariable logistic regression and Cox models, respectively. New-onset AF during hospitalization occurred in 6.5%, 10.4%, and 17.1% of patients in the first, second and third CRP tertiles, respectively (p trend <0.0001). In a multivariable logistic regression, adjusting for clinical variables and ejection fraction, compared with patients in the first CRP tertile, the odds ratios for AF were 1.5 (95% confidence interval 0.9 to 2.5, p = 0.15) and 2.0 (95% confidence interval 1.2 to 3.3, p = 0.008) in patients in the second and third CRP tertiles, respectively (p for trend = 0.007). In a Cox multivariate analysis, CRP remained an independent predictor of new-onset AF at 1 year. In conclusion, in a large cohort of patients with AMI, there was a graded positive association between increased CRP and new-onset AF. Inflammation may contribute to the development of AF in the setting of AMI.
authors: Department of Cardiology, Rambam Medical Center and the Rappaport Family Faculty of Medicine, Technion Medical School, Haifa, Israel. daronson@tx.technion.ac.il
authors: Doron
authors: D
authors: Aronson
authors: Monther
authors: M
authors: Boulos
authors: Abeer
authors: A
authors: Suleiman
authors: Salma
authors: S
authors: Bidoosi
authors: Yoram
authors: Y
authors: Agmon
authors: Michael
authors: M
authors: Kapeliovich
authors: Rafael
authors: R
authors: Beyar
authors: Walter
authors: W
authors: Markiewicz
authors: Haim
authors: H
authors: Hammerman
authors: Mahmoud
authors: M
authors: Suleiman
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D010359:Patient Readmission; D011446:Prospective Studies; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein; D003404:Creatinine