High-Sensitivity C-Reactive Protein is a Predictor of Subsequent Atrial High-Rate Episodes in Patients with Pacemakers and Preserved Ejection Fraction
Open Access
- 16 November 2020
- journal article
- research article
- Published by MDPI AG in Journal of Clinical Medicine
- Vol. 9 (11), 3677
- https://doi.org/10.3390/jcm9113677
Abstract
Atrial fibrillation (AF) is associated with morbidity and mortality. Modern pacemakers can detect atrial high-rate episodes (AHREs) as a surrogate for AF. It remains controversial whether inflammation is a cause or a consequence of AF. This study investigated whether the inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) can predict subsequent AHREs. This study gathered prospective data from patients with pacemakers and a left ventricle EF ≥ 50% between 2015 and 2019. The hs-CRP and other cardiac biomarkers at baseline and device-detected AHREs, defined as atrial rate ≥ 180 bpm and duration ≥ 6 min, were determined. Cox regression analysis was used to estimate the independent predictors for AHREs. A total of 171 consecutive patients were included. During the median follow-up of 614 days, 66 patients (39%) developed subsequent AHREs. In the univariate Cox regression analysis, sick sinus syndrome (p = 0.005), prior AF (p < 0.001), mitral A velocity (p = 0.008), and hs-CRP (p = 0.013) showed significant association with the increased risk of AHREs. In the multivariate Cox regression model, hs-CRP (HR = 1.121, 95% confidence interval = 1.015–1.238, p = 0.024) retained its significance. Our results suggest that elevated hs-CRP could predict subsequent AHREs and that inflammation could play a role in AF pathogenesis in patients with preserved EF.This publication has 35 references indexed in Scilit:
- Subclinical Atrial Fibrillation and the Risk of StrokeThe New England Journal of Medicine, 2012
- Detection of atrial high-rate events by continuous Home Monitoring: clinical significance in the heart failure-cardiac resynchronization therapy populationEP Europace, 2011
- Does Elevated C-Reactive Protein Increase Atrial Fibrillation Risk?: A Mendelian Randomization of 47,000 Individuals From the General PopulationJournal of the American College of Cardiology, 2010
- Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)European Heart Journal, 2010
- Current concepts in the pathogenesis of atrial fibrillationAmerican Heart Journal, 2009
- The role of the post-cardioversion time course of hs-CRP levels in clarifying the relationship between inflammation and persistence of atrial fibrillationHeart, 2008
- Effects of C-Reactive Protein and the Third and Fourth Components of Complement (C3 and C4) on Incidence of Atrial FibrillationThe American Journal of Cardiology, 2006
- Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of CardiologyJournal of the American Society of Echocardiography, 2005
- Inflammation as a Risk Factor for Atrial FibrillationCirculation, 2003
- Problems in echocardiographic volume determinations: Echocardiographic-angiographic correlations in the presence or absence of asynergyThe American Journal of Cardiology, 1976