Relation of C-reactive protein and new-onset atrial fibrillation in patients with acute myocardial infarction
Relation of C-reactive protein and new-onset atrial fibrillation in patients with acute myocardial infarction
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DOI：
10.1016/j.amjcard.2007.04.014
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发表时间：
2007-09-01
影响因子：
2.8
通讯作者：
Suleiman, Mahmoud
中科院分区：
文献类型：
--
作者：
Aronson, Doron;Boulos, Monther;Suleiman, Mahmoud
最近的研究表明全身炎症在心房颤动（AF）的发生和维持中起作用。强烈的炎症反应是急性心肌梗死（AMI）期间组织损伤反应的组成部分。然而，没有关于AMI患者中炎症与AF之间相关性的信息。我们研究了1，209例因AMI入院的患者。在症状发作后12至24小时内通过高灵敏度测定法测量C反应蛋白（CRP）。分别采用多变量logistic回归和考克斯模型分析CRP与住院期间和1年时新发AF的关系。在第一、第二和第三CRP三分位数中，住院期间新发AF的发生率分别为6.5%、10.4%和17.1%（p趋势< 0.0001）。在多变量logistic回归分析中，调整临床变量和射血分数，与CRP第一个三分位数的患者相比，AF的比值比为1.5（95%置信区间0.9 - 2.5，p = 0.15）和2.0（95%置信区间1.2 - 3.3，p = 0.008）（趋势p = 0.007）。在考克斯多变量分析中，CRP仍然是1年时新发AF的独立预测因子。总之，在一个大的AMI患者队列中，CRP升高和新发AF之间存在分级正相关。炎症可能有助于AMI背景下AF的发展。(C)2007年爱思唯尔公司All rights reserved.
Recent studies have implicated systemic inflammation in the genesis and maintenance of atrial fibrillation (AF). A robust inflammatory response is an integral component of the response to tissue injury during acute myocardial infarction (AMI). However, there is no information concerning the association between inflammation and AF in patients with AMI. We studied 1,209 patients admitted for AMI. C-reactive protein (CRP) was measured by a high-sensitivity assay within 12 to 24 hours after symptom onset. The relation between CRP and new-onset AF occurring during the hospital course and at 1 year was analyzed using multivariable logistic regression and Cox models, respectively. New-onset AF during hospitalization occurred in 6.5%, 10.4%, and 17.1% of patients in the first, second and third CRP tertiles, respectively (p trend < 0.0001). In a multivariable logistic regression, adjusting for clinical variables and ejection fraction, compared with patients in the first CRP tertile, the odds ratios for AF were 1.5 (95% confidence interval 0.9 to 2.5, p = 0.15) and 2.0 (95% confidence interval 1.2 to 3.3, p = 0.008) in patients in the second and third CRP tertiles, respectively (p for trend = 0.007). In a Cox multivariate analysis, CRP remained an independent predictor of new-onset AF at 1 year. In conclusion, in a large cohort of patients with AMI, there was a graded positive association between increased CRP and new-onset AF. Inflammation may contribute to the development of AF in the setting of AMI. (C) 2007 Elsevier Inc. All rights reserved.