title: Interleukin-2 serum levels variations in recent onset atrial fibrillation are related with cardioversion outcome.
abstract: We evaluated the hypothesis that a relationship exists between inflammation and the outcome of pharmaceutical cardioversion with amiodarone in recent onset atrial fibrillation. We studied 86 patients with symptomatic recent onset AF and coexisting hypertension and/or chronic stable coronary artery disease. All study participants underwent evaluation with a standardized protocol including echocardiography, cytokine level measurement [interleukin-2 (IL-2), interleukin-6 (IL-6) and high sensitivity C reactive protein (hsCRP)] on admission and at 48h, and administration of intravenous amiodarone. By 48h, 70 patients cardioverted to sinus rhythm. Median serum IL-2 levels on admission were higher in non-cardioverted compared to cardioverted patients (P=0.002). At 48h, non-cardioverted had significantly higher IL-6 (P=0.005) and hsCRP values (P=0.001) compared to cardioverted. Multivariate logistic regression analysis showed that lower IL-2 admission levels were a powerful independent predictor for successful cardioversion (OR: 0.154, 95% CI: 0.043-0.552, P=0.004). In patients with hypertension and/or chronic stable coronary artery disease and symptomatic recent onset AF, low serum IL-2 levels on admission are associated with successful cardioversion with amiodarone. This observation highlights the role of inflammation in AF and might have further prognostic and therapeutic implications.
authors.affiliation: 2nd Academic Department of Cardiology, Attikon University Hospital, University of Athens Medical School, 19 Kentauron Street, 15237 Filothei, Athens, Greece. ioannis.c.rizos@otenet.gr
authors.forename: Ioannis
authors.initials: I
authors.lastname: Rizos
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.forename: Angelos G
authors.initials: AG
authors.lastname: Rigopoulos
authors.forename: Spiros
authors.initials: S
authors.lastname: Dragomanovits
authors.forename: Andreas S
authors.initials: AS
authors.lastname: Kalogeropoulos
authors.forename: Sotirios
authors.initials: S
authors.lastname: Papathanasiou
authors.forename: Eleftherios A
authors.initials: EA
authors.lastname: Sakadakis
authors.forename: Dimitrios Th
authors.initials: DT
authors.lastname: Kremastinos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D003430:Cross-Sectional Studies; D017984:Enoxaparin / Q000008:administration & dosage; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D007262:Infusions, Intravenous; D007376:Interleukin-2 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D012074:Remission Induction; D013995:Time; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D017984:Enoxaparin; D005343:Fibrinolytic Agents; C508600:IL6 protein, human; D007376:Interleukin-2; D015850:Interleukin-6; D002097:C-Reactive Protein; D000638:Amiodarone