Hypertension and paroxysmal atrial fibrillation: a novel predictive role of high sensitivity C-reactive protein in cardioversion and long-term recurrence

Rizos, Ioannis; Rigopoulos, Angelos; Καλογερόπουλος, Ανδρέας; Tsiodras, Sotirios; Dragomanovits, S.; Sakadakis, Eleftherios; Faviou, E.; Kremastinos, Dimitrios Th.

doi:10.1038/jhh.2009.89

Cited by 17 publications

(6 citation statements)

References 41 publications

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“…Several large, prospective cohort studies have found elevated CRP levels can predict the development of new onset of AF as well as AF recurrence after catheter ablation or cardioversion (11)(12)(13). CRP per se does not increase the risk of AF but it is a surrogate marker for an underlying inflammatory process (14,15).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Safety and efficacy outcomes of atrial fibrillation ablation in patients with rheumatoid arthritis

et al. 2022

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Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Safety and efficacy outcomes of atrial fibrillation ablation in patients with rheumatoid arthritis

et al. 2022

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“…Atrial fibrillation is responsible for markedly increased cardiovascular morbidity, and mortality and has been associated with various cardiovascular disorders, predominantly with hypertension, coronary artery disease, heart failure and valvular heart disease [ 1 ]. Various factors, including atrial remodeling and inflammation, have been implicated in the pathogenesis and perpetuation of AF; nevertheless the exact mechanism still remains uncertain [ 2 - 6 ]. Electrical remodeling is the possible substrate for persistence of AF after the initial event [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation

Καλογερόπουλος

Tsiodras

Rigopoulos

et al. 2011

BMC Cardiovasc Disord

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BackgroundMatrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are essential for the cardiac extracellular matrix (ECM) remodeling. We investigated differences in serum levels of these markers between patients with atrial fibrillation (AF) and sinus rhythm (SR).MethodsSerum levels of MMP-2, MMP-3, MMP-9 and TIMP-1 were measured in 86 patients: 27 on SR without any AF history, 33 with paroxysmal and 26 with permanent AF. All subjects had essential hypertension, normal systolic function and no coronary artery disease.ResultsPatients with AF had higher MMP-2, MMP-3 and MMP-9 and lower TIMP-1 compared to SR subjects (all p < 0.001). Paroxysmal AF was associated with higher MMP-2 levels compared to permanent AF (p < 0.001). Matrix metalloproteinase-9 but not MMP-3 was higher in permanent compared to paroxysmal AF group (p < 0.001). Patients with AF had lower levels of TIMP-1 compared to those with SR while permanent AF subjects had lower TIMP-1 levels than those with paroxysmal AF (p < 0.001 for both comparisons). Lower TIMP-1 was the only independent factor associated with AF (OR: 0.259, 95%CI: 0.104-0.645, p = 0.004).ConclusionsIn hypertensives, paroxysmal AF and permanent AF differ with respect to serum MMPs. Increased MMP-2 is associated with paroxysmal, whereas increased MMP-9 with permanent AF. Additionally, lower levels of TIMP-1 had a strong association with AF incidence.

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“…Inflammation, which can cause structural and electrical changes in the atrium, predisposing patients to AF, could be connected with the changes in the laboratory parameters such as CRP and white blood cells (WBC) [ 26 , 27 ]. For instance, CRP has been reported as a risk factor for AF episodes, including AF recurrences after successful cardioversion [ 28 ]. Similarly, WBC is one of the predictors of AF after cardiac surgery [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

New-Onset Atrial Fibrillation in Acute Myocardial Infarction Is a Different Phenomenon than Other Pre-Existing Types of That Arrhythmia

Raczkowska-Golanko

Młodziński

Raczak

et al. 2022

JCM

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(1) Background: Atrial fibrillation (AF) in acute myocardial infarction (AMI) could worsen the prognosis. Yet, there is no definitive answer to whether new-onset AF (NOAF) is a more aggravating diagnosis than other types of that arrhythmia. The purpose of our study was to compare in-hospital clinical course and outcomes of NOAF patients contrary to patients with other pre-existing types of AF. (2) Methods: AMI patients hospitalized in the high-volume cardiological center within 2017–2018 were included in the study. NOAF was noticed in 106 (11%) patients, 95 (10%) with an AF history and AF during AMI formed the AF group, 60 (6%) with an AF history but without AF during AMI constituted the Prior-AF group, and 693 (73%) patients were without an AF before and during AMI. Medical history, routinely monitored clinical parameters, and in-hospital outcomes were analyzed between the groups. (3) Results: NOAF patients, contrary to others, initially had the highest high-sensitivity troponin I (hsTnI), B-type natriuretic peptide (BNP), C-reactive protein (CRP), and glucose levels, and the lowest potassium concentration, with the worst profile of changes for that parameter within the first four days of hospitalization. NOAF patients had the highest rate of ST-elevated AMI (40%), the longest hospitalization (p < 0.001), and the highest in-hospital mortality (p < 0.001). Not NOAF, but other AF groups (AF and Prior-AF groups) were more burdened with the previous comorbidities. (4) Conclusions: NOAF could be a distinct phenomenon in AMI patients, identifying those with the worst clinical in-hospital course and outcomes as compared to other types of AF.

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Hypertension and paroxysmal atrial fibrillation: a novel predictive role of high sensitivity C-reactive protein in cardioversion and long-term recurrence

Cited by 17 publications

References 41 publications

Safety and efficacy outcomes of atrial fibrillation ablation in patients with rheumatoid arthritis

Safety and efficacy outcomes of atrial fibrillation ablation in patients with rheumatoid arthritis

Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation

New-Onset Atrial Fibrillation in Acute Myocardial Infarction Is a Different Phenomenon than Other Pre-Existing Types of That Arrhythmia

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