Abstract 18339: Biomarkers and Recurrence of Atrial Fibrillation After Successful Cardioversion: Results of a Meta-Analysis

Abstract

Background: An increasing body of evidence suggests the role of inflammation in the genesis and perpetuation of atrial fibrillation (AF). However, inconsistent results have been published with regard to the role of inflammatory markers in predicting the maintenance of sinus rhythm after a successful direct current cardioversion (DCCV).

Methods: Using Ovid and EMBASE, we searched for literature published prior to December 2011. Of the 405 studies identified, 16 studies with 1054 patients (501 with and 553 without AF relapse) were included for analysis.

Results: Mean CRP, BNP group levels from each study were recorded and the standardized difference in mean and odds ratio was calculated. Using the fixed effects model (FEM), CRP and BNP group levels were significantly higher in patients with recurrence of AF post DCCV (odds ratio (OR) for CRP = 2.30 (CI: 1.63-3.26); for BNP = 4.44 (CI: 3.11-6.33)). There was some evidence of heterogeneity (p-value for CRP < 0.002; p-value for BNP group = 0.001). Using random effects model, the effect size for CRP increased to 2.53 (CI: 1.33-4.82) and for BNP group the effect size increased to 6.38 (CI: 1.58-25.82). Publication bias was not evident for CRP and BNP group (p-value 0.43 and 0.24 respectively).

Conclusion: Increased CRP and BNP levels are associated with greater risk of AF recurrence after successful DCCV. The use of these markers for the prediction of those who maintain sinus rhythm after DCCV appears promising but requires further study.