High-Sensitivity CRP Predicts Mortality in A-Fib Patients
Highest hs-CRP levels associated with significantly increased all-cause and cardiovascular mortality risk
THURSDAY, Dec. 29 (HealthDay News) -- Higher levels of high-sensitivity C-reactive protein (hs-CRP) are associated with increased all-cause and cardiovascular mortality in patients with atrial fibrillation (AF), independent of other risk factors, according to a study published in the Jan. 1 issue of The American Journal of Cardiology.
José Hermida, M.D., Ph.D., of the University of Navarra in Pamploma, Spain, and colleagues analyzed data from 293 patients with AF who participated in the Atherosclerosis Risk In Communities study. The participants were recruited from four communities throughout the United States, with baseline examinations conducted from 1987 to 1989 and three additional exams conducted every three years. Levels of hs-CRP were measured in blood samples obtained at the fourth visit and categorized in tertiles (<2, 2.00 to 5.99, or ≥6 mg/L).
The researchers found that, over a median follow-up of 9.4 years, 134 participants died (46 percent). The hs-CRP levels were positively associated with all-cause and cardiovascular mortality in a dose-response manner. After adjusting for age, gender, history of cardiovascular diseases, and cardiovascular risk factors, the hazard ratio (HR) of all-cause mortality associated with the highest versus the lowest tertile of hs-CRP was 2.52. A similar trend was observed for cardiovascular mortality (HR, 1.90). Adding hs-CRP to a predictive model including the Congestive heart failure, Hypertension, Age >75 years, Diabetes, and previous Stroke or transient ischemic attack (CHADS2) score was associated with a significant improvement of the C-statistic for total mortality.
"Our study is one of the first to show a clear association between hs-CRP levels and total mortality among patients with AF in a general population, even after adjustment for potential confounders," write the authors. "We also found that hs-CRP levels improved risk classification beyond that of the CHADS2 score, suggesting that hs-CRP measurements might be included in the risk assessment of patients with AF.