Title : Use of C-reactive protein for prediction of sinus rhythm maintenance after pharmacologic cardioversion in patients with metabolic syndrome
Abstract:
Background: Approximately 50% of patients undergoing cardioversion usually present with recurrence of Atrial Fibrillation(AF) within 3–6?months of cardioversion despite ongoing antiarrhythmic treatment(AAD). Inflammation have been involved in the pathogenesis of both metabolic syndrome(MS) and AF. Evidence has indicated that inflammatory changes is essential for recurrence of AF. Therefore, identifying patients at high risk of AF recurrence remains challenging.
Objective: We tested hypothesis: increased C-reactive protein (CRP) levels are associated with greater risk of AF recurrence after pharmacologic cardioversion (PCV).
Methods: We conducted a multicenter observational cross-sectional study.215 consecutive adult participants(≥18 and <65years of age) were recruited with MS and symptomatic AF(paroxysmal and persistent),admitted at 6 general cardiology Health Care Clinics ,who underwent PCV, during 1 calendar year follow-up period,stratified in two group according to CRP levels,(105 participants(50 females and 55 males) with level of CRP ≥3mg/l, and 110(58 females and 52 males) with level of CRP <3mg/l). Recurrence of AF,during follow-up period was defined as the study end-point.
Results: After the follow-up of 1.0 years,only(31.8%) of patients with MS and CRP levels above the cut-off of 3 mg/l, remain in sinus rhythm,compared to (64.7%) of patients with MS and CRP levels below the cut-off of 3 mg/l.(p=0.002).
Conclusions: CRP an easily determined marker in everyday clinical practice may provide significant prognostic information regarding sinus rhythm maintenance and could be useful for predicting recurrence of AF after successful pharmacologic cardioversion in clinical practice.
Key words:CRP levels, Inflammation,Metabolic Syndrome and Atrial Fibrillation.
