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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.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [342]
In the citing paper
“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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Metadata
- 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 › Hematology › 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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