Use of C-reactive protein for prediction of sinus rhythm maintenance after pharmacologic cardioversion in patients with Metabolic Syndrome

Abstract

Abstract Background Approximately 50% of patients undergoing cardioversion present with a recurrence of Atrial Fibrillation ( AF) within 3–6 months of cardioversion despite ongoing antiarrhythmic treatment (AAD). Inflammation has been involved in the pathogenesis of both metabolic syndrome (MS) and atrial fibrillation. 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 the hypothesis: increased C-reactive protein (CRP) levels are associated with a 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). They were admitted at six general cardiology Health Care Clinics, underwent PCV, and during a one calendar year follow-up period, were stratified into two groups 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 one year, 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 the recurrence of AF after successful pharmacologic cardioversion in clinical practice.