Abstract 17179: The Effect of Inflammation on Incident Atrial Fibrillation: Results of a Systematic Review and Meta-Analysis
Background: Inflammation is considered an important component of the substrate predisposing to atrial fibrillation (AF). Indeed, recent data suggest that inflammation may predict response to therapy and that treatment of inflammation may improve outcomes in AF. The aim of this meta-analysis was to determine the association between raised inflammatory markers and AF.
Methods: Ovid and EMBASE were searched to identify prospective cohort and case-control studies that have evaluated the association between raised inflammatory markers and incident AF.
Results: Of the 405 articles identified, 17 studies that enrolled a total of 3439 individuals met the inclusion criteria. Mean levels of C-reactive protein (CRP), B-type natriuretic peptide (BNP) from each study were recorded and the standardized difference in mean and odds ratio was calculated. Using the fixed effects model (FEM), CRP and IL-6 levels were significantly higher in AF patients (odds ratio (OR) for CRP = 2.34 (CI: 1.82-3.01); for IL6 = 2.78 (CI: 1.79-4.32)). There was no evidence of heterogeneity (p-value for CRP = 0.44; p-value for IL-6 = 0.28). Under FEM, the OR for BNP was 4.15 (CI: 3.42-5.04) and heterogeneity was present (p-value < 0.001). Using random effects model, the effect size increased to 7.08 (CI: 3.93-12.76). Publication bias was not evident for CRP, IL-6 or BNP (p-value 0.83, 0.20 and 0.11, respectively).
Conclusion: Raised inflammatory markers are associated with an increased risk of incident AF. The underlying mechanisms whereby inflammation may promote the genesis of AF warrant further investigation.
- © 2012 by American Heart Association, Inc.