Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri City, Gyounggi-do Postal code: 11923, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Wangsipri Street 222, Seongdong-Gu, Seoul Postal code: 04763, Republic of Korea.
Int J Cardiol. 2019 Feb 15;277:240-246. doi: 10.1016/j.ijcard.2018.10.070. Epub 2018 Oct 28.
Inflammation has been reported to cause atrial fibrillation (AF). However, it remains unclear whether C-reactive protein (CRP) levels predict AF. We investigated whether there was an association between serum CRP levels and the development of AF.
A total of 10,030 subjects aged between 40 and 69 years were enrolled and followed biennially over a 12-year period in the Ansan-Ansung cohort study. Serum CRP levels were measured at baseline and high-sensitivity CRP (hsCRP) levels were measured at every revisit. AF was identified using 12-lead standard electrocardiography. Inverse probability of treatment weighting was applied to balance the confounders of AF development between groups.
Serum CRP levels were higher in subjects with AF at baseline and those with new-onset AF than in those without AF. Cox-regression analysis showed that high CRP levels (>3 mg/L) and intermediate CRP levels (1-3 mg/L) at baseline were not associated with a higher risk of new-onset AF compared with low CRP levels (<1 mg/L) after adjustments for covariates. The weighted incidences of AF also did not differ according to the CRP levels. In contrast, persistent elevation of CRP or hsCRP levels (≥1 mg/L at all visits) was associated with a higher risk of AF compared with nonpersistent elevation of CRP or hsCRP levels after adjustment for covariates in both unweighted and weighted cohorts.
A high CRP level at a single measurement was not associated with the risk of AF, whereas persistently elevated CRP levels independently predicted the development of AF.
炎症与心房颤动（房颤）有关。然而，目前尚不清楚 C 反应蛋白（CRP）水平是否可预测房颤。我们研究了血清 CRP 水平与房颤发生之间是否存在关联。
共纳入 10030 名年龄在 40 至 69 岁之间的受试者，在安山-安城队列研究中，每两年随访一次，随访时间为 12 年。在基线时测量血清 CRP 水平，在每次随访时测量高敏 CRP（hsCRP）水平。通过 12 导联标准心电图确定房颤。应用逆概率治疗加权法平衡两组间房颤发展的混杂因素。
基线时有房颤的患者和新发房颤的患者的血清 CRP 水平高于无房颤的患者。Cox 回归分析表明，在校正了协变量后，基线时 CRP 水平较高（>3mg/L）和中等（1-3mg/L）与新发房颤的风险增加无关，而 CRP 水平较低（<1mg/L）。加权房颤发生率也与 CRP 水平无关。相反，CRP 或 hsCRP 水平持续升高（所有就诊时≥1mg/L）与校正协变量后调整后的房颤风险较高相关，而 CRP 或 hsCRP 水平非持续性升高则不相关。
单次 CRP 水平升高与房颤风险无关，而持续升高的 CRP 水平独立预测房颤的发生。
