C-reactive protein for prediction of atrial fibrillation recurrence after catheter ablation
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(2020) 20:427
RESEARCH ARTICLE
Open Access
C-reactive protein for prediction of atrial fibrillation recurrence after catheter ablation Pascal B. Meyre1,2* , Christian Sticherling1,2, Florian Spies1,2, Stefanie Aeschbacher1,2, Steffen Blum1,2, Gian Voellmin1,2, Antonio Madaffari1,2, David Conen1,3, Stefan Osswald1,2, Michael Kühne1,2† and Sven Knecht1,2†
Abstract Background: Inflammation plays an important role in the initiation and progression of atrial fibrillation (AF), but data about the relationship between subclinical inflammation and recurrence of AF after catheter ablation remains poorly studied. We aimed to assess whether plasma levels of C-reactive protein (CRP) are associated with long-term AF recurrence following catheter ablation. Methods: Prior to the intervention, plasma CRP concentrations were measured in patients who underwent first catheter ablation for AF. AF recurrence was evaluated after 12 months and defined as any AF episode longer than 30 s recorded on either 12-lead electrocardiogram, 24-h Holter or 7-day Holter monitoring. Multivariable adjusted Cox models were constructed to examine the association of CRP levels and AF recurrence. Results: Of the 711 patients (mean age: 61 years, 25% women) included in this study, 247 patients (35%) experienced AF recurrence after ablation. Patients who were in the highest CRP quartile had a higher rate of recurrent AF compared to those who were in the lowest quartile (53.4 vs. 33.1% at 1 year of follow-up; P = 0.004). The adjusted hazard ratios (aHR) of recurrent AF across increasing quartiles of CRP were 1.0 (reference), 1.26 (95% confidence interval [CI], 0.86–1.84), 1.15 (95% CI, 0.78–1.70) and 1.60 (95% CI, 1.10–2.34) (P trend = 0.015). A similar effect was observed when CRP was analyzed as continuous variable (aHR per unit increase, 1.21; 95% CI, 1.05–1.39; P = 0.009). When a predefined CRP cut-off of 3 mg/l was applied, patients with CRP levels of 3 mg/l or above had a higher risk of AF recurrence than those with levels below (aHR, 1.44; 95% CI, 1.06–1.95; P = 0.019). Conclusions: Increasing pre-interventional CRP levels are associated with a higher risk of AF recurrence in patients undergoing catheter ablation for AF. Trail registration: ClinicalTrials.gov identifier, NCT03718364. Keywords: Atrial fibrillation, Catheter ablation, C-reactive protein, Recurrence
* Correspondence: [email protected] † Michael Kühne and Sven Knecht contributed equally, shared last authors 1 Division of Cardiology, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland 2 Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a
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