Abstract 2030: High Sensitivity C-Reactive Protein Predict Early-Onset Atrial Fibrillation in Patients with Acute Myocardial Infarction Who have No Atrial Dilatation
Introduction There is increasing evidence that inflammation may play a role in the pathogenesis of atrial fibrillation (AF) and acute myocardial infarction (AMI). It has been demonstrated that high-sensitivity C-reactive protein (hs CRP) is significantly increased in some types of AF. However, it is not clear whether hs CRP is related to the occurrence of AF in patients with AMI, which is inflammatory response.
Hypothesis We assessed the hypothesis that inflammation contribute to early-onset AF developing in patients with AMI who show no atrial dilatation.
Methods We prospectively studied 386 AMI patients without history of AF from May 2005 to April 2007. All Patients were divided into low (<32cc/m2, n=308) and high left atrial(LA) volume index groups (>32cc/m2, n=78). Variables of left ventricular ejection fraction, E/E′, deceleration time, diastolic filling patterns, the degree of CAD, culprit lesion, hs CRP, NT proBNP, and comorbid diseases were evaluated.
Results Eighteen (5.8%) patients in low LA volume index group and twenty (20.5%) patients in high LA volume index group showed early onset AF. In thirty six (94.7 %) patients, AF was transient. In low LA volume index group, the risk of AF increased with age (OR 1.06; 95% CI 1.01–1.104, P=0.017), E/E′(OR 1.12; 95% CI 1.03–1.22, P=0.006), NT proBNP(OR 1.0;95%CI 1–1.1, P=0.012), and if hs CRP>16mg/L (OR 6.2; 95% CI 2.13–17.82, P= 0.001) by univariate analysis. Multivariate logistic regression showed that hs CRP>16mg/L(OR 5.6; 95%CI 1.69–18.9, P=0.005) and age (OR 1.1;95% CI: 1.02 –1.13, p=0.013) were independent predictors of AF in low LA volume index group. In high LA volume index group, the risk of AF increased with age(OR 1.08; 95% CI 1.01–1.15, P=0.03) by univariate analysis. Multivariate logistic regression show that age (OR 1.11;95% CI: 1.02–1.21, p=0.018) was independent predictor of AF in high LA volume index group.
Conclusions hs CRP predicted early-onset AF in patients with AMI who have no atrial dilatation. This finding suggests that inflammatory response is responsible for early-onset AF in patients with AMI who have no atrial enlargement.