Inflammation as a risk factor for atrial fibrillation
Inflammation as a risk factor for atrial fibrillation
复制标题
DOI：
10.1161/01.cir.0000103131.70301.4f
复制
发表时间：
2003-12-16
期刊：
影响因子：
37.8
通讯作者：
Chung, MK
中科院分区：
文献类型：
--
作者：
Aviles, RJ;Martin, DO;Chung, MK
背景--C反应蛋白(CRP)升高所确定的全身性炎症的存在与房颤(AF)的持续性有关。C反应蛋白与房颤预测之间的关系尚未在大规模人群队列中进行研究。方法和结果：5806名参加心血管健康研究的受试者在基线时进行了C反应蛋白测定和心血管评估。患者获得平均6.9+/-1.6(中位数7.8)年的随访。房颤是通过自我报告的病史和基线时的心电图以及随访时的心电图和出院诊断来确定的。使用单变量和多变量分析来评估CRP作为预测房颤基线和未来发展的指标。基线时，315名受试者(5%)患有房颤。与C反应蛋白第一四分位数(<0.97 mg/L)相比，第四四分位数(>；3.41 mg/L)受试者房颤发生率较高(7.4%比3.7%，调整后OR1.8，95%可信区间1.2to2.5；P=0.002)。在基线时无房颤的5491名受试者中，897名(16%)在随访期间发生了房颤。基线C反应蛋白预测未来发生房颤的风险更高(调整后的第四与第一四分位数的危险比为1.31，95%可信区间为1.08至1.58；P=0.005)。当作为一个连续变量处理时，C反应蛋白升高预示着未来发生房颤的风险增加(调整后1-SD增加的危险比为1.24；95%可信区间为1.11至1.4；P<；0.001)。结论：C反应蛋白不仅与房颤的存在有关，而且还可预测患者发生房颤的风险增加。
Background - The presence of systemic inflammation determined by elevations in C-reactive protein (CRP) has been associated with persistence of atrial fibrillation (AF). The relationship between CRP and prediction of AF has not been studied in a large population-based cohort.Methods and Results - CRP measurement and cardiovascular assessment were performed at baseline in 5806 subjects enrolled in the Cardiovascular Health Study. Patients were followed up for a mean of 6.9 +/- 1.6 ( median 7.8) years. AF was identified by self-reported history and ECGs at baseline and by ECGs and hospital discharge diagnoses at follow-up. Univariate and multivariate analyses were used to assess CRP as a predictor of baseline and future development of AF. At baseline, 315 subjects (5%) had AF. Compared with subjects in the first CRP quartile ( < 0.97 mg/L), subjects in the fourth quartile ( > 3.41 mg/L) had more AF (7.4% versus 3.7%, adjusted OR 1.8, 95% CI 1.2 to 2.5; P = 0.002). Of 5491 subjects without AF at baseline, 897 ( 16%) developed AF during follow-up. Baseline CRP predicted higher risk for developing future AF ( fourth versus first quartile adjusted hazard ratio 1.31, 95% CI 1.08 to 1.58; P = 0.005). When treated as a continuous variable, elevated CRP predicted increased risk for developing future AF ( adjusted hazard ratio for 1-SD increase, 1.24; 95% CI 1.11 to 1.40; P < 0.001).Conclusions - CRP is not only associated with the presence of AF but may also predict patients at increased risk for future development of AF.