Activated inflammation is related to the incidence of atrial fibrillation in patients with acute myocardial infarction.
OBJECTIVE
The purpose of this study was to investigate the relationship between the new onset of atrial fibrillation (AF) and inflammation in the early phase of acute myocardial infarction (AMI). Background Serial interaction between inflammation and the incidence of AF is not fully understood in the early phase of AMI.


METHODS
Two hundred fifty-nine consecutive patients with AMI were studied. electrocardiogram monitoring was recorded continuously for >7 days. Serial inflammation markers, cardiac enzymes, coronary angiogram and echocardiography were obtained in all patients.


RESULTS
One hundred seventy-six patients were enrolled. AF was present in 24 patients (14%), and occurred on day 2.7 ± 1.4 after admission. Serial measurements of WBC and C-reactive protein (CRP) with/without AF were as follows. WBC levels of day 5-7 were 9.3 ± 3.5 vs. 7.5 ± 2.4 × 10(3)/µL, p=0.04, and CRP levels of day 2-4, 5-7, 8-14 were 12.6 ± 9.4 vs. 4.7 ± 5.3 mg/dL, p<0.001, 12.3 ± 10.4 vs. 5.2 ± 5.2 mg/dL, p=0.01, and 8.5 ± 7.7 vs. 2.7 ± 4.2 mg/dL, p=0.005, respectively. Those were significantly higher in the patients with AF. In multivariate logistic regression analysis, CRP levels of day 2-4 were independently higher in the patients with AF (odds ratio (OR) 1.15, 95% confidence (CI) 1.04-1.27).


CONCLUSIONS
AF in the early phase of AMI occurs a few days after the onset of AMI, which is independently related to the activated inflammation. AF in this period persists for only a short duration.
Cardiology Department, Yamanashi Prefectural Central Hospital, Japan. yocchan_ika@hotmail.co.jp
Tohru
T
Yoshizaki
Ken
K
Umetani
Yuri
Y
Ino
Souichirou
S
Takahashi
Masahiko
M
Nakamura
Toshikuni
T
Seto
Kazunori
K
Aizawa
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D011446:Prospective Studies; D013997:Time Factors
D018836:Inflammation Mediators; D002097:C-Reactive Protein