Document Detail

Association between C-reactive protein and recurrence of atrial fibrillation after successful electrical cardioversion: a meta-analysis.
MedLine Citation:
PMID:  17433956     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We conducted a systematic review and meta-analysis of observational studies to examine the association between baseline C-reactive protein (CRP) levels and the recurrence of atrial fibrillation (AF) after successful electrical cardioversion (EC). BACKGROUND: Current evidence links AF to the inflammatory state. Inflammatory indexes such as CRP have been related to the development and persistence of AF. However, inconsistent results have been published with regard to the role of CRP in predicting sinus rhythm maintenance after successful EC. METHODS: Using PubMed, the Cochrane clinical trials database, and EMBASE, we searched for literature published June 2006 or earlier. In addition, a manual search was performed using all review articles on this topic, reference lists of papers, and abstracts from conference reports. Of the 225 initially identified studies, 7 prospective observational studies with 420 patients (229 with and 191 without AF relapse) were finally analyzed. RESULTS: Overall, baseline CRP levels were greater in patients with AF recurrence. The standardized mean difference in the CRP levels between the patients with, and those without AF was 0.35 units (95% confidence interval 0.01 to 0.69); test for overall effect z-score = 2.00 (p = 0.05). The heterogeneity test showed that there were significant differences between individual studies (p = 0.02; I(2) = 60.2%). Further analysis revealed that differences between the CRP assays possibly account for this heterogeneity. CONCLUSIONS: Our meta-analysis suggests that increased CRP levels are associated with greater risk of AF recurrence, although there was significant heterogeneity across the studies. The use of CRP levels in predicting sinus rhythm maintenance appears promising but requires further study.
Tong Liu; Guangping Li; Lijian Li; Panagiotis Korantzopoulos
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2007-04-02
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  49     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-16     Completed Date:  2007-05-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1642-8     Citation Subset:  AIM; IM    
Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
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MeSH Terms
Age Distribution
Atrial Fibrillation / diagnosis*,  therapy*
C-Reactive Protein / analysis,  metabolism*
Confidence Intervals
Electric Countershock*
Enzyme-Linked Immunosorbent Assay
Follow-Up Studies
Inflammation Mediators / analysis
Middle Aged
Prospective Studies
Randomized Controlled Trials as Topic
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Distribution
Reg. No./Substance:
0/Inflammation Mediators; 9007-41-4/C-Reactive Protein
Comment In:
J Am Coll Cardiol. 2007 Apr 17;49(15):1649-50   [PMID:  17433957 ]

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