Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation
Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation
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DOI：
10.1016/j.ehj.2004.04.025
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发表时间：
2004-07-01
影响因子：
39.3
通讯作者：
Panaretou, M
中科院分区：
文献类型：
--
作者：
Dernellis, J;Panaretou, M
背景 关于 C 反应蛋白 (CRP) 降低对心房复发的影响的直接信息很少。方法和结果 我们对 104 名经历过持续性 AF 且 CRP 中位浓度为 1.14 mg/dL（最小值 = 0.01，最大值 = 2.58）的持续性 AF 患者进行了双剂量糖皮质激素治疗（16 mg 甲泼尼龙，持续 4 周，逐渐减少至 4 mg，持续 4 个月）和安慰剂的比较。甲基泼尼松龙将复发性房颤（主要终点）从安慰剂组的 50% 降低到糖皮质激素组的 9.6%，将永久性房颤（扩大终点）从安慰剂组的 29% 降低到糖皮质激素组的 2%。甲基强的松龙的生存分布显着不同（主要终点和扩展终点，P < 0.001）。在多变量 Cox 分析中，随访期间的平均 CRP 浓度是主要终点（相对风险为 6.72（P = 0.006））和扩展终点（相对风险为 11.67（P = 0.0006））的显着预测因子。 结论 CRP 浓度是复发性和永久性 AF 的危险因素。甲基泼尼松龙成功预防复发性和永久性房颤。 (C) 2004 年由 Elsevier Ltd 代表欧洲心脏病学会出版。
Background Little direct information is available on the effect of C-Reactive Protein (CRP) lowering on the reduction of recurrent atrial. fibrillation (AF).Methods and Results We compared tow-dose glucocorticoid therapy (16 mg methylprednisolone for 4 weeks tapered to 4 mg for 4 months) and placebo in 104 patients who had experienced persistent AF with a median concentration of CRP 1.14 mg/dL (min = 0.01, max = 2.58). Methy[prednisolone reduced recurrent AF (primary end-point) from 50% in the placebo group to 9.6% in the glucocorticoid group and permanent AF (expanded end-point) from 29% in the placebo group to 2% in the glucocorticoid group. Survival distributions for methylprednisolone were significantly different (for both primary and expanded end-point, P < 0.001). In multivariate Cox analysis, average CRP concentrations during follow-up were significant predictors of the primary end-point, with a relative risk 6.72 (P = 0.006) and the expanded end-point, with a relative risk of 11.67 (P = 0.0006).Conclusions CRP concentration is a risk factor for recurrent and permanent AF. Methylprednisolone successfully prevents recurrent and permanent AF. (C) 2004 Published by Elsevier Ltd on behalf of The European Society of Cardiology.