scholarly journals Reappraising the role of baseline plasma C-reactive protein levels on recurrence after catheter ablation of persistent atrial fibrillation: insight from EARNEST-PVI trial

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Okada ◽  
K Inoue ◽  
N Tanaka ◽  
M Masuda ◽  
Y Furukawa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Controlled Trial ◽  
Persistent Atrial Fibrillation ◽  
Subclinical Inflammation ◽  
C Reactive Protein ◽  
Private Company ◽  
Reactive Protein ◽  
Af Recurrence

Abstract Background Subclinical inflammation is an important pathogenesis of developing and sustaining atrial fibrillation (AF). Because AF itself contribute to the inflammatory response, the role of baseline subclinical inflammation on AF recurrence after catheter ablation (CA) remains controversial in patients with persistent AF. Purpose To evaluate whether baseline plasma C-reactive protein (CRP) levels, a sensitive marker of inflammation, are associated with AF recurrence following CA. Methods The analysis was performed from the EARNEST-PVI trial, a randomized controlled trial designed to assess a CA strategy for persistent AF, which was conducted in the Osaka region of Japan. A total of 441 patients (median age, 67 years; 26% female; 25% long-standing persistent AF) whose plasma CRP levels were measured at baseline were included in this study. Results At baseline, a median (interquartile range) of plasma CRP level was 0.10 [0.06–0.19] mg/dl. Plasma CRP levels significantly increased at discharge (0.83 [0.21–1.84] mg/dl, p<0.001) and decreased 1 year after CA (0.10 [0.05–0.20] mg/dl, p=0.040) compared to the baseline value. During the follow-up of 1 year, 115 patients (26%) experienced AF recurrence, and the incidence was significantly higher in 124 patients with low CRP levels at baseline (cut-off ≤0.06 mg/dl) than the other 317 patients (33.9% vs. 23.0%, p=0.017). After adjustment of age, gender, body mass index, long-standing persistent AF, CA strategy, and plasma brain natriuretic peptide levels, low plasma CRP levels was a significant predictor of AF recurrence (hazard ratio, 1.51; 95% confidence interval, 1.02–2.24; p=0.042). Conclusions Low plasma CRP levels at baseline predicted AF recurrence in the EARNEST-PVI trial. Reappraising the role of CRP on AF recurrence may be needed in patients with persistent AF. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): Johnson & Johnson KK

scholarly journals C-reactive protein for prediction of atrial fibrillation recurrence after catheter ablation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pascal B. Meyre ◽  
Christian Sticherling ◽  
Florian Spies ◽  
Stefanie Aeschbacher ◽  
Steffen Blum ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Holter Monitoring ◽  
Continuous Variable ◽  
C Reactive Protein ◽  
Cox Models ◽  
Reactive Protein ◽  
Hazard Ratios ◽  
Unit Increase ◽  
Af Recurrence

Abstract Background Inflammation plays an important role in the initiation and progression of atrial fibrillation (AF), but data about the relationship between subclinical inflammation and recurrence of AF after catheter ablation remains poorly studied. We aimed to assess whether plasma levels of C-reactive protein (CRP) are associated with long-term AF recurrence following catheter ablation. Methods Prior to the intervention, plasma CRP concentrations were measured in patients who underwent first catheter ablation for AF. AF recurrence was evaluated after 12 months and defined as any AF episode longer than 30 s recorded on either 12-lead electrocardiogram, 24-h Holter or 7-day Holter monitoring. Multivariable adjusted Cox models were constructed to examine the association of CRP levels and AF recurrence. Results Of the 711 patients (mean age: 61 years, 25% women) included in this study, 247 patients (35%) experienced AF recurrence after ablation. Patients who were in the highest CRP quartile had a higher rate of recurrent AF compared to those who were in the lowest quartile (53.4 vs. 33.1% at 1 year of follow-up; P = 0.004). The adjusted hazard ratios (aHR) of recurrent AF across increasing quartiles of CRP were 1.0 (reference), 1.26 (95% confidence interval [CI], 0.86–1.84), 1.15 (95% CI, 0.78–1.70) and 1.60 (95% CI, 1.10–2.34) (P trend = 0.015). A similar effect was observed when CRP was analyzed as continuous variable (aHR per unit increase, 1.21; 95% CI, 1.05–1.39; P = 0.009). When a predefined CRP cut-off of 3 mg/l was applied, patients with CRP levels of 3 mg/l or above had a higher risk of AF recurrence than those with levels below (aHR, 1.44; 95% CI, 1.06–1.95; P = 0.019). Conclusions Increasing pre-interventional CRP levels are associated with a higher risk of AF recurrence in patients undergoing catheter ablation for AF. Trail registration ClinicalTrials.gov identifier, NCT03718364.

scholarly journals Renal function and arrhythmia outcomes in persistent atrial fibrillation patients after catheter ablation: subanalysis of the EARNEST-PVI trial

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Tanaka ◽  
K Inoue ◽  
M Masuda ◽  
Y Furukawa ◽  
A Hirata ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Renal Function ◽  
Catheter Ablation ◽  
Estimated Glomerular Filtration Rate ◽  
Persistent Atrial Fibrillation ◽  
Renal Outcome ◽  
Private Company ◽  
Funding Sources ◽  
The Mean ◽  
Af Recurrence

Abstract Background Atrial fibrillation (AF) reduces the renal function. Renal dysfunction and AF often coexist. Catheter ablation (CA) of persistent AF can maintain a sinus rhythm and may improve the renal function. Purpose We sought to elucidate whether the estimated glomerular filtration rate (eGFR) in patients with persistent AF was increased after CA, especially with the presence of an AF recurrence. Methods We enrolled 487 persistent AF patients whose eGFR data were available both before and 1-year after the CA out of 512 patients in the EARNEST-PVI trial. Results The mean age was 65±9 year and 113 patients (24.8%) had long-standing persistent AF. We compared the eGFR at baseline with that 1-year after the CA. AF recurrences were recognized in 118 patients (25.8%). The eGFR was similar between the group without recurrence and that with recurrence at baseline (without AF recurrence vs. with AF recurrence; 63.8±14.3 vs. 62.7±13.6 mL/min/1.73m2, p=0.46). In patients without AF recurrence, the G1, G2, G3a, G3b, G4, and G5 were 13 (3.8%), 198 (58.4%), 98 (28.9%), 26 (7.7%), 3 (0.9%), and 1 (0.3%), respectively at baseline. In the patients with AF recurrence, the G1, G2, G3a, G3b, G4, and G5 were 3 (2.5%), 68 (57.8%), 38 (32.2%), 6 (5.1%), 3 (2.5%), and 0 (0%), respectively at baseline. The ΔeGFR was significantly higher in the patients without AF recurrence than in those with AF recurrence (without AF recurrence vs. with AF recurrence; 5.1 [−0.3, 10.8] vs. 3.0 [−3.0, 7.6], p=0.0033). In the patients without AF recurrence, a better eGFR class at 1-year after the CA than in those before the CA was recognized in 75 patients (22.1%), while it was recognized in 19 patients (16.1%) with AF recurrences. Conclusion Successful catheter ablation in patients with persistent AF led to a better renal outcome. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): This study was funded by Medtronic, Johnson & Johnson, and Abbott.

scholarly journals Role of tissue C-reactive protein in atrial cardiomyocytes of patients undergoing catheter ablation of atrial fibrillation: pathogenetic implications

EP Europace ◽  
2011 ◽  
Vol 13 (8) ◽  
pp. 1133-1140 ◽  
Author(s):  
M. L. Narducci ◽  
G. Pelargonio ◽  
A. Dello Russo ◽  
M. Casella ◽  
L. M. Biasucci ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
C Reactive Protein ◽  
Atrial Cardiomyocytes ◽  
Reactive Protein

scholarly journals Relationship between serum angiopoietin-like 4 levels and recurrence of atrial fibrillation

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098839
Author(s):  
Zhongping Ning ◽  
Xinming Li ◽  
Xi Zhu ◽  
Jun Luo ◽  
Yingbiao Wu
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Peroxisome Proliferator ◽  
C Reactive Protein ◽  
Peroxisome Proliferator Activated Receptor ◽  
Reactive Protein ◽  
New Onset

Objective To investigate the association between serum angiopoietin-like 4 (ANGPTL4) levels and recurrence of atrial fibrillation (AF) after catheter ablation. Methods This retrospective study recruited patients with AF undergoing catheter ablation and they were divided into two groups (new-onset AF group and recurrent AF group). Demographic, clinical, and laboratory parameters were collected. Results A total of 192 patients with AF were included, including 69 patients with recurrence of AF. Serum ANGPTL4 levels were lower in patients with recurrent AF than in those with new-onset AF. Serum ANGPTL4 levels were positively correlated with superoxide dismutase and peroxisome proliferator-activated receptor γ, and negatively correlated with the CHA2DS2-VASC score, left atrial diameter, and levels of brain natriuretic peptide, malondialdehyde, high-sensitivity C-reactive protein, and interleukin-6. The receiver operating characteristic curve showed that the best cut-off for recurrent AF was serum ANGPTL4 levels  < 19.735 ng/mL, with a sensitivity and specificity of 63.9% and 74.5%, respectively. Serum ANGPTL4 levels were significantly associated with recurrence and new onset of AF (odds ratio, 2.241; 95% confidence interval, 1.081–4.648). Conclusions Serum ANGPTL4 levels are lower in patients with recurrent AF than in those with new-onset AF, and are associated with cardiac hypertrophy, oxidative stress, and inflammation.

C-Reactive Protein, Interleukin 6, and N-Terminal Pro-Brain Natriuretic Peptide Following Cardioversion of Atrial Fibrillation: Is There a Role of Biomarkers in Arrhythmia Recurrence?

Angiology ◽  
2010 ◽  
Vol 62 (4) ◽  
pp. 310-316 ◽  
Author(s):  
Stavroula N. Psychari ◽  
Dionyssios Chatzopoulos ◽  
Efstathios K. Iliodromitis ◽  
Thomas S. Apostolou ◽  
Dimitrios T. Kremastinos
Keyword(s):  
Atrial Fibrillation ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Interleukin 6 ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Association Between C-Reactive Protein and Atrial Fibrillation Recurrence After Catheter Ablation: A Meta-analysis

2013 ◽  
Vol 36 (9) ◽  
pp. 548-554 ◽  
Author(s):  
Zhouqin Jiang ◽  
Limeng Dai ◽  
Zhiyuan Song ◽  
Huakang Li ◽  
Maoqin Shu
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Meta Analysis ◽  
Atrial Fibrillation Recurrence ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Role of clinical and biochemical inflammation in structural progression of patients with psoriatic arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e002038
Author(s):  
Carina Borst ◽  
Farideh Alasti ◽  
Josef S Smolen ◽  
Daniel Aletaha
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Psoriatic Arthritis ◽  
Radiographic Progression ◽  
Controlled Trial ◽  
The Other ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Structural Progression

ObjectiveTo determine the contribution of clinical and biochemical inflammation to structural progression of patients with psoriatic arthritis (PsA).MethodsWe analysed patients from the Infliximab Multinational Psoriatic Arthritis Controlled Trial 2 trial (infliximab vs placebo). We obtained total modified Sharp/van-der-Heijde Scores from baseline and year one images, and swollen joint counts (SJC) and levels of C reactive protein (CRP) throughout the second half of year 1 (5 measurements) from 74 placebo-treated patients. We computed radiographic progression, time-averaged SJC (taSJC) and CRP (taCRP) values and assessed their impact on structural progression by logistic regression analysis. We further categorised patients as ‘active’ (+) or ‘inactive’ (−) based on their taSJC (cut-off point: 2/66 joints) and taCRP (cut-off point: 0.5 mg/dL) and compared radiographic progression across three groups (double inactive, single active, double active).ResultsORs for progression were 1.24 (95 % CI 1.04 to 1.47; p=0.016) for taSJC and 6.08 (95 % CI 1.12 to 33.03; p=0.036) for taCRP. When predictors were dichotomised (+ vs −), differences were maintained between taSJC+ and taSJC− patients (1.05±3.21 and 0.56±2.30, respectively), as well as for taCRP+ vs taCRP− patients (1.14±3.23 and 0.05±2.37, respectively). Progression was intermediate in the presence of abnormalities of one but not the other inflammatory variable, indicating increasing radiographic progression with increasing inflammation (p=0.05).ConclusionIn patients with PsA, both clinical and biochemical inflammation have an impact on structural progression. Overall, progression is smallest in the absence of both clinical and biochemical inflammation, higher when either clinical or biochemical inflammation is present and highest with both clinical and biochemical inflammation.

scholarly journals Is Catheter Ablation Better Than Antiarrhythmic Drugs for the Treatment of Atrial Fibrillation?

2020 ◽  
Vol 29 (02) ◽  
pp. 131-140
Author(s):  
Balaji Natarajan ◽  
Srishti Nayak ◽  
Ramdas G. Pai
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Persistent Atrial Fibrillation ◽  
Poor Quality ◽  
Treatment Side Effects ◽  
Randomized Controlled Studies ◽  
Antiarrhythmic Medications ◽  
Better Than

AbstractLong-standing atrial fibrillation is associated with significant morbidity including stroke and development of heart failure. Patients also report poor quality of life as a result of debilitating symptoms or treatment side effects from antiarrhythmic medications. Radio frequency or cryothermal mediated catheter ablation has a central role in the management of symptomatic patients with paroxysmal or persistent atrial fibrillation. Circumferential pulmonary vein isolation is vital to the success of this therapy and other ancillary techniques have been described, especially for persistent atrial fibrillation. Several randomized controlled studies have been reported over the last two decades studying important clinical outcomes in patients with atrial fibrillation. In this article, we aim to provide a review of the major studies that have helped define the role of catheter ablation in the management of symptomatic atrial fibrillation in patients with both diseased and structurally normal hearts.

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