Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation
- PMID: 15231367
- DOI: 10.1016/j.ehj.2004.04.025
Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation
Abstract
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 low-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). Methylprednisolone 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.
Comment in
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New hope for the prevention of recurrent atrial fibrillation.Eur Heart J. 2004 Jul;25(13):1089-90. doi: 10.1016/j.ehj.2004.04.035. Eur Heart J. 2004. PMID: 15231364 No abstract available.
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Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation.Eur Heart J. 2004 Oct;25(19):1761-2. doi: 10.1016/j.ehj.2004.08.002. Eur Heart J. 2004. PMID: 15451157 No abstract available.
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