Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation

Abstract

CRP concentration is a risk factor for recurrent and permanent AF. Methylprednisolone successfully prevents recurrent and permanent AF.

Hypertension and paroxysmal atrial fibrillation: a novel predictive role of high sensitivity C-reactive protein in cardioversion and long-term recurrence

“…This is indicative of an important role of sustained inflammatory process and validation of these observations in patients with distinct and homogeneous cardiac substrates is necessary. Furthermore, our findings are suggestive of a potential therapeutic benefit, after an aggressive anti-inflammatory treatment, for example with anti-inflammatory agents, 19 involving the improvement of AF cardioversion outcome and the reduction of AF recurrence rate in patients with arterial hypertension. The risks and benefits of such an approach should be further studied in carefully designed clinical trials.…”

“…Recently, other similar studies that included patients with PAF have shown that pre-cardioversion CRP is an important predictor for cardioversion outcome and maintenance of sinus rhythm after successful cardioversion. 10,19 The usage of a non-ultrasensitive assay to measure CRP serum levels in these studies may have led to an overstatement of the importance of these associations. To further corroborate this, a recent meta-analysis investigating the role of CRP in restoration of sinus rhythm and AF recurrence revealed a great heterogeneity in the analysed studies and regarded differences in the used CRP assay as an important source for this heterogeneity.…”

“…Inflammation in atrial fibrillation due to hypertension I Rizos et al have shown that higher baseline levels of hsCRP are associated with failure of cardioversion and with higher AF relapse rates. 6,7,10,19,[21][22][23] Others, however, do not prove that hsCRP is a potent determinant of either cardioversion outcome or AF recurrence. 8,24,25 The divergence in these results could be attributed, at least in part, to the significant variability of the precipitating cardiovascular substrate (including heart failure, valvular heart disease, cardiomyopathies) and AF type (paroxysmal, persistent or permanent).…”

“…17 Earlier reports showed that the success rate of cardioversion after amiodarone administration in patients with PAF is almost 80% in the first 24 h (1:4 case-control ratio) 18 and the recurrence rate of PAF after successful cardioversion with amiodarone is about 50% (1:1 case-control ratio). 19 Hence, it was estimated, that to detect a 60% difference in hsCRP levels between patients with a positive and negative cardioversion outcome, a power of 80%, and a two-tailed a of 0.05, 13 non-cardioverted and 50 cardioverted will be required for each arm of the study (1:4 case-control ratio). Likewise, according to the aforementioned criteria, 27 patients with AF recurrence and 27 without AF recurrence will have to be involved, in each arm of the study (1:1 case-control ratio).…”

Capabilities of 99mTc-pyrphotech single-photon emission computed tomography in combination with myocardial perfusion scintigraphy in the evaluation of inflammatory changes in the heart of patients with persistent atrial fibrillation

“…Эти дан-ные могут свидетельствовать об общей воспалительной реакции организма в ответ на частые пароксизмы ФП. Аналогичные результаты получены и во многих других исследованиях, посвященных изучению роли латентного воспаления в патогенезе указанного нарушения ритма сердца [21][22][23]. Таким образом, в работе показано, что в 20% случаев причиной «идиопатической» формы ФП может являться латентный лимфоцитарный или полиморфно-клеточный миокардит вирусной этиологии.…”