High-sensitivity C-reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion

Eiichi Watanabe, Tomoharu Arakawa, Tatsushi Uchiyama, Itsuo Kodama, Hitoshi Hishida

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Backgrounds: Cardioversion for atrial fibrillation (AF) is the most effective treatment for the restoration of sinus rhythm (SR). Recently, an elevated level of hs-CRP has been shown to be associated with AF burden, suggesting that inflammation increases the propensity for persistence of AF. We examined whether the level of high-sensitivity C-reactive protein (hs-CRP) was predictive of the outcome of cardioversion for AF. Methods and results: One hundred and six patients with a history of symptomatic AF lasting ≥ 1 day (age 63 ± 14 years, mean ± S.D.) underwent cardioversion. Echocardiography and hs-CRP assay were performed immediately prior to cardioversion. SR was restored in 84 patients (79%). By using selected cutoff values, multiple discriminant analysis revealed significant associations between successful cardioversion and a shorter duration of AF (AF duration ≤ 36 days, odds ratio (OR), 0.98; 95% confidence interval (CI), 0.97-0.99), smaller left atrial diameter (left atrial diameter ≤ 40 mm, OR 0.82, 95% CI 0.71-0.94), better-preserved left ventricular ejection fraction (left ventricular ejection fraction ≥ 60%, OR 0.92, 95% CI 0.86-0.99), and lower hs-CRP level (hs-CRP ≤ 0.12 mg/dL, OR 0.33, 95% CI 0.21-0.51). During a follow-up period of 140±144 days, AF recurred in 64 patients (76%). By using a cutoff value of hs-CRP ≥ 0.06 mg/dL, Cox proportional-hazards regression model found that only hs-CRP level was an independent predictor of AF recurrence (OR 5.30, 95% CI 2.46-11.5) after adjustment for coexisting cardiovascular risks. When patients were divided by the hs-CRP level of 0.06 mg/dL, percentage of maintenance of SR below and above the cutoff was 53% and 4%, respectively (log-rank test, p < 0.0001). Conclusions: hs-CRP level determined prior to cardioversion represents an independent predictor of both successful cardioversion for AF and the maintenance of SR after conversion.

Original languageEnglish
Pages (from-to)346-353
Number of pages8
JournalInternational Journal of Cardiology
Volume108
Issue number3
DOIs
Publication statusPublished - 14-04-2006

Fingerprint

Electric Countershock
C-Reactive Protein
Atrial Fibrillation
Maintenance
Odds Ratio
Confidence Intervals
Stroke Volume
Discriminant Analysis
Proportional Hazards Models
Echocardiography
Inflammation
Recurrence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{b80885f565a046c59b87f2a3e80677f8,
title = "High-sensitivity C-reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion",
abstract = "Backgrounds: Cardioversion for atrial fibrillation (AF) is the most effective treatment for the restoration of sinus rhythm (SR). Recently, an elevated level of hs-CRP has been shown to be associated with AF burden, suggesting that inflammation increases the propensity for persistence of AF. We examined whether the level of high-sensitivity C-reactive protein (hs-CRP) was predictive of the outcome of cardioversion for AF. Methods and results: One hundred and six patients with a history of symptomatic AF lasting ≥ 1 day (age 63 ± 14 years, mean ± S.D.) underwent cardioversion. Echocardiography and hs-CRP assay were performed immediately prior to cardioversion. SR was restored in 84 patients (79{\%}). By using selected cutoff values, multiple discriminant analysis revealed significant associations between successful cardioversion and a shorter duration of AF (AF duration ≤ 36 days, odds ratio (OR), 0.98; 95{\%} confidence interval (CI), 0.97-0.99), smaller left atrial diameter (left atrial diameter ≤ 40 mm, OR 0.82, 95{\%} CI 0.71-0.94), better-preserved left ventricular ejection fraction (left ventricular ejection fraction ≥ 60{\%}, OR 0.92, 95{\%} CI 0.86-0.99), and lower hs-CRP level (hs-CRP ≤ 0.12 mg/dL, OR 0.33, 95{\%} CI 0.21-0.51). During a follow-up period of 140±144 days, AF recurred in 64 patients (76{\%}). By using a cutoff value of hs-CRP ≥ 0.06 mg/dL, Cox proportional-hazards regression model found that only hs-CRP level was an independent predictor of AF recurrence (OR 5.30, 95{\%} CI 2.46-11.5) after adjustment for coexisting cardiovascular risks. When patients were divided by the hs-CRP level of 0.06 mg/dL, percentage of maintenance of SR below and above the cutoff was 53{\%} and 4{\%}, respectively (log-rank test, p < 0.0001). Conclusions: hs-CRP level determined prior to cardioversion represents an independent predictor of both successful cardioversion for AF and the maintenance of SR after conversion.",
author = "Eiichi Watanabe and Tomoharu Arakawa and Tatsushi Uchiyama and Itsuo Kodama and Hitoshi Hishida",
year = "2006",
month = "4",
day = "14",
doi = "10.1016/j.ijcard.2005.05.021",
language = "English",
volume = "108",
pages = "346--353",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

High-sensitivity C-reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion. / Watanabe, Eiichi; Arakawa, Tomoharu; Uchiyama, Tatsushi; Kodama, Itsuo; Hishida, Hitoshi.

In: International Journal of Cardiology, Vol. 108, No. 3, 14.04.2006, p. 346-353.

Research output: Contribution to journalArticle

TY - JOUR

T1 - High-sensitivity C-reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion

AU - Watanabe, Eiichi

AU - Arakawa, Tomoharu

AU - Uchiyama, Tatsushi

AU - Kodama, Itsuo

AU - Hishida, Hitoshi

PY - 2006/4/14

Y1 - 2006/4/14

N2 - Backgrounds: Cardioversion for atrial fibrillation (AF) is the most effective treatment for the restoration of sinus rhythm (SR). Recently, an elevated level of hs-CRP has been shown to be associated with AF burden, suggesting that inflammation increases the propensity for persistence of AF. We examined whether the level of high-sensitivity C-reactive protein (hs-CRP) was predictive of the outcome of cardioversion for AF. Methods and results: One hundred and six patients with a history of symptomatic AF lasting ≥ 1 day (age 63 ± 14 years, mean ± S.D.) underwent cardioversion. Echocardiography and hs-CRP assay were performed immediately prior to cardioversion. SR was restored in 84 patients (79%). By using selected cutoff values, multiple discriminant analysis revealed significant associations between successful cardioversion and a shorter duration of AF (AF duration ≤ 36 days, odds ratio (OR), 0.98; 95% confidence interval (CI), 0.97-0.99), smaller left atrial diameter (left atrial diameter ≤ 40 mm, OR 0.82, 95% CI 0.71-0.94), better-preserved left ventricular ejection fraction (left ventricular ejection fraction ≥ 60%, OR 0.92, 95% CI 0.86-0.99), and lower hs-CRP level (hs-CRP ≤ 0.12 mg/dL, OR 0.33, 95% CI 0.21-0.51). During a follow-up period of 140±144 days, AF recurred in 64 patients (76%). By using a cutoff value of hs-CRP ≥ 0.06 mg/dL, Cox proportional-hazards regression model found that only hs-CRP level was an independent predictor of AF recurrence (OR 5.30, 95% CI 2.46-11.5) after adjustment for coexisting cardiovascular risks. When patients were divided by the hs-CRP level of 0.06 mg/dL, percentage of maintenance of SR below and above the cutoff was 53% and 4%, respectively (log-rank test, p < 0.0001). Conclusions: hs-CRP level determined prior to cardioversion represents an independent predictor of both successful cardioversion for AF and the maintenance of SR after conversion.

AB - Backgrounds: Cardioversion for atrial fibrillation (AF) is the most effective treatment for the restoration of sinus rhythm (SR). Recently, an elevated level of hs-CRP has been shown to be associated with AF burden, suggesting that inflammation increases the propensity for persistence of AF. We examined whether the level of high-sensitivity C-reactive protein (hs-CRP) was predictive of the outcome of cardioversion for AF. Methods and results: One hundred and six patients with a history of symptomatic AF lasting ≥ 1 day (age 63 ± 14 years, mean ± S.D.) underwent cardioversion. Echocardiography and hs-CRP assay were performed immediately prior to cardioversion. SR was restored in 84 patients (79%). By using selected cutoff values, multiple discriminant analysis revealed significant associations between successful cardioversion and a shorter duration of AF (AF duration ≤ 36 days, odds ratio (OR), 0.98; 95% confidence interval (CI), 0.97-0.99), smaller left atrial diameter (left atrial diameter ≤ 40 mm, OR 0.82, 95% CI 0.71-0.94), better-preserved left ventricular ejection fraction (left ventricular ejection fraction ≥ 60%, OR 0.92, 95% CI 0.86-0.99), and lower hs-CRP level (hs-CRP ≤ 0.12 mg/dL, OR 0.33, 95% CI 0.21-0.51). During a follow-up period of 140±144 days, AF recurred in 64 patients (76%). By using a cutoff value of hs-CRP ≥ 0.06 mg/dL, Cox proportional-hazards regression model found that only hs-CRP level was an independent predictor of AF recurrence (OR 5.30, 95% CI 2.46-11.5) after adjustment for coexisting cardiovascular risks. When patients were divided by the hs-CRP level of 0.06 mg/dL, percentage of maintenance of SR below and above the cutoff was 53% and 4%, respectively (log-rank test, p < 0.0001). Conclusions: hs-CRP level determined prior to cardioversion represents an independent predictor of both successful cardioversion for AF and the maintenance of SR after conversion.

UR - http://www.scopus.com/inward/record.url?scp=33644752794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644752794&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2005.05.021

DO - 10.1016/j.ijcard.2005.05.021

M3 - Article

C2 - 15964643

AN - SCOPUS:33644752794

VL - 108

SP - 346

EP - 353

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 3

ER -