title: Long-term prognostic value of baseline C-reactive protein in predicting recurrence of atrial fibrillation after electrical cardioversion.
abstract: BACKGROUND
  An increasing body of evidence links atrial fibrillation (AF) to the inflammatory state. It has been suggested that increased C-reactive protein (CRP) levels are associated with greater risk of AF recurrence at short- and mid-term.
  
  
  OBJECTIVE
  We sought to investigate the association between CRP and long-term risk of AF recurrence.
  
  
  METHODS
  This was a prospective observational study. We investigated the association between baseline CRP levels and recurrence of AF over a 3-year follow-up period after successful electrical cardioversion (EC). A total of 60 patients were studied (mean age: 68.4 +/- 7.2 years, 60% men). All patients were receiving amiodarone for sinus rhythm maintenance. We further divided the study population into three tertiles according to the values of baseline CRP (tertile 1: <0.43 mg/dL; tertile 2: 0.43-0.8 mg/dL; tertile 3: >0.8 mg/dL).
  
  
  RESULTS
  Overall, 75% of patients relapsed into AF during the 3-year study period. AF recurrence was significantly lower in the 1st CRP tertile group (P = 0.039). The Kaplan-Meier survival analysis showed that the rate of AF recurrence was significantly lower in the lowest CRP tertile (log rank; P < 0.001). In a multivariable Cox regression model adjusted for other potential covariates, only CRP (upper two tertiles) was an independent predictor of AF recurrence (heart rate: 6.3, 95% confidence interval: 3.1-12.7, P < 0.001).
  
  
  CONCLUSIONS
  Our findings suggest that baseline CRP levels before EC have an independent prognostic value in predicting the long-term risk of AF recurrence.
authors.affiliation: Department of Cardiology, University of Ioannina, School of Medicine, Ioannina, Greece. p.korantzopoulos@yahoo.gr
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Korantzopoulos
authors.forename: Kallirroi
authors.initials: K
authors.lastname: Kalantzi
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Siogas
authors.forename: John A
authors.initials: JA
authors.lastname: Goudevenos
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control; D002097:C-Reactive Protein / Q000032:analysis*; D004554:Electric Countershock / Q000401:mortality*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein