Inflammation as a risk factor for atrial fibrillation
Abstract
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.
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Although biomarkers such as natriuretic peptides are elevated in AF patients, there is insufficient data to suggest that blood-based parameters are independent markers for AF.
“Although biomarkers such as natriuretic peptides are elevated in AF patients, there is insufficient data to suggest that blood-based parameters are independent markers for AF.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [342]
In men, a U-shaped association has been reported between physical activity and AF, in which sedentary lifestyle and vigorous exercise both are associated with increased AF risk, whereas moderate activity is protective.
“In men, a U-shaped association has been reported, in which sedentary lifestyle and vigorous exercise both are associated with increased AF risk,41,44,45 whereas moderate activity is protective.46”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [44]
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- Authors
- Aviles, R. J., Martin, D. O., Apperson-Hansen, C., Houghtaling, P. L., Rautaharju, P., Kronmal, R. A., Tracy, R. P., Van Wagoner, D. R., Psaty, B. M., Lauer, M. S., & Chung, M. K.
- Affiliations
- University of Vermont (US)
- From the Department of Cardiovascular Medicine (R.J.A., D.O.M., D.R.V.W., M.S.L., M.K.C.), Department of Biostatistics (C.A.-H., P.L.H.), The Cleveland Clinic Foundation, Cleveland, Ohio; Cardiovascular Health Research Unit (B.M.P.), University of Washington, Seattle, Wash; Wake Forest University School of Medicine (P.R.), Winston-Salem, NC; Department of Pathology and Biochemistry, (R.P.T.), University of Vermont, Colchester, Vt; and the CHS Coordinating Center (R.A.K.), Seattle, Wash. Dr Aviles is...
- ORCID
- Venue
- Circulation
- Published
- 2003-12-16
- Volume
- 108
- Issue
- 24
- Pages
- 3006-3010
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2120386224
- Cited by
- 1,425
- References
- 27
- Citations by year
- 2026: 44 · 2025: 52 · 2024: 59 · 2023: 54 · 2022: 53 · 2021: 45 · 2020: 70 · 2019: 56 · 2018: 75 · 2017: 69 · 2016: 73 · 2015: 69 · 2014: 82 · 2013: 75 · 2012: 78
- FWCI
- 25.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc035129-010)
- National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01HC-85083, N01HC15103, N01HC85082, N01 HC85086, N01HC85080, HL-65412, R01HL065412, N01-HC85079, N01-HC85084, N01HC35129)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Blood properties and coagulation
- Keywords
- atrial fibrillation, C-reactive protein, systemic inflammation, risk prediction, Cardiovascular Health Study, cardiovascular risk factors
- MeSH terms
- Aged, Atrial Fibrillation, C-Reactive Protein, Cross-Sectional Studies, Female, Humans, Inflammation, Longitudinal Studies, Male, Risk Factors
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