Serum High-Sensitivity C-Reactive Protein Levels and the Risk of Atrial Fibrillation in Japanese Population: the Circulatory Risk in Communities Study

Abstract

Aim: This study aimed to investigate the association between the serum high-sensitivity C-reactive protein (hs-CRP) levels and incident atrial fibrillation risk in the general Japanese population, who have lower hs-CRP levels than the Western population, and assess whether the association is modified by sex, overweight, hypertension, and smoking status. Methods: We conducted a prospective study in 6517 Japanese men and women aged 40–79 years without atrial fibrillation at baseline and enrolled in the Circulatory Risk in Communities Study (2002–2008). The hs-CRP levels were measured using the latex particle-enhanced immunonephelometric assay. Atrial fibrillation was identified using standard 12-lead electrocardiograms and information on physician-diagnosed atrial fibrillation history from the follow-up surveys. We used a Cox proportional hazard regression stratified by community. Results: During a median follow-up of 11 years, 127 new cases of atrial fibrillation (74 and 53 cases among men and women, respectively) were found. Compared to the lowest quintile of hs-CRP levels, the multivariable hazard ratios (95% confidence intervals) were 2.54 (1.17–5.50), 2.28 (1.06–4.93), 2.92 (1.37–6.23), and 2.77 (1.30–5.91) for the second, third, fourth, and fifth (highest) quintiles, respectively. There was no significant effect modification by sex, overweight, hypertension, and smoking status ( P for interaction > 0.05). Conclusions: Elevated hs-CRP levels were significantly associated with increased risk of atrial fibrillation in the Japanese population. The association of hs-CRP levels with incident atrial fibrillation did not vary according to sex, overweight, hypertension status, or smoking status.

Serum High-Sensitivity C-Reactive Protein Levels and the Development of Atrial Fibrillation in a General Japanese Population ― The Hisayama Study ―

“…A similar association was also reported by another population-based cohort study in Japan, recently. 24 In addition, the present study showed that the subjects with a persistently high serum hs-CRP level showed an approximately values both in 1988 and in 2002). In contrast, the "decreased" subgroup (i.e., subjects in whom serum hs-CRP levels were higher than the cut-off values in 1988 but lower in 2002) was not associated with a risk of AF.…”

Biomarkers for Predicting the Occurrence and Progression of Atrial Fibrillation: Soluble Suppression of Tumorigenicity 2 Protein and Tissue Inhibitor of Matrix Metalloproteinase-1

“…Moreover, the most prominent risk factors for AF development, such as age, sex, increased BMI, hypertension, and HF, have all been related to elevated natriuretic peptide concentrations. Previous studies showed that patients with AF had signifcantly higher CRP levels than the SR group [20], and elevated hs-CRP levels were signifcantly associated with an increased risk of AF [35][36][37]. However, circulating BNP and CRP are known biomarkers for systemic circulation and can be infuenced by many factors, such as HF and acute or chronic infammation.…”

Development and validation of a predictive model for new-onset atrial fibrillation in sepsis based on clinical risk factors

“…Some studies have noted an association between leukocyte counts and AF ( 30 ). However, more studies focus on CRP as a primary predictor of NOAF ( 31 , 32 ). CRP could act on monocytes/macrophages, vascular endothelial cells, and smooth muscle cells to secrete pro-inflammatory molecules to induce cardiovascular disease ( 33 ).…”