High-Sensitivity C-Reactive Protein is a Predictor of Subsequent Atrial High-Rate Episodes in Patients with Pacemakers and Preserved Ejection Fraction
Journal
Cleveland Clinic Journal of Medicine
Journal Volume
9
Journal Issue
11
Pages
3677
Date Issued
2020
Author(s)
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�V1.238, 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. c 2020 by the authors. Licensee MDPI, Basel, Switzerland.
SDGs
Other Subjects
angiotensin receptor antagonist; antiarrhythmic agent; beta adrenergic receptor blocking agent; C reactive protein; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; diuretic agent; high sensitivity C reactive protein; unclassified drug; aged; Article; atrial fibrillation; atrial high rate episode; confidence interval; controlled study; female; follow up; hazard ratio; heart ejection fraction; heart left ventricle; heart rate; human; major clinical study; male; proportional hazards model; prospective study
Type
journal article