Predicting atrial fibrillation recurrence with circulating inflammatory markers in patients in sinus rhythm at high risk for atrial fibrillation: data from the GISSI atrial fibrillation trial.
Background Inflammation may play a significant role in
the pathogenesis of atrial fibrillation (AF).
Objectives To examine the roles of three systemic
inflammatory markers in predicting recurrent AF.
Methods The association between the plasma
concentrations of high-sensitivity C reactive protein
(hsCRP), interleukin-6 (IL-6) and pentraxin-3 (PTX3) with
echocardiographic parameters and with the time to first
recurrence of AF was tested in 382 patients with
a history of AF but in sinus rhythm at randomisation,
enrolled in the GISSI-AF biohumoral study.
Results Baseline PTX3 was related to left atrial, but not
to left ventricular chamber volume. During one year of
follow-up, 204 patients (53.1%) had a recurrent AF.
There were no significant differences in baseline median
[Q1eQ3] plasma concentrations of IL-6, hsCRP and PTX3
among patients with (2.11 [1.47e3.74] pg/ml, 3.30
[1.40e6.80] mg/l and 4.66 [3.27e6.97] ng/ml,
respectively) or without recurrent AF (2.09 [1.37e2.90]
pg/ml, p\ubc0.182; 3.00 [1.10e6.20] mg/l, p\ubc0.333; 5.09
[3.22e7.98] ng/ml, p\ubc0.637). At 6 and 12 months
follow-up, AF patients had significantly higher
concentrations of IL-6 and PTX3 than those in sinus
rhythm, and those with most recent episodes of AF had
higher hsCRP. Baseline levels of IL-6, hsCRP or PTX3
were not significantly associated with a higher risk of
recurrence of AF.
Conclusion In patients with a history of AF, but without
significant left ventricular dysfunction or heart failure,
inflammatory biomarkers may be raised but are, at best,
weak predictors of the risk for first recurrence of AF