Chang Hee Kwon1, Jung Gyu Kang2, Hyun Jong Lee3, Nan Hee Kim4, Joo-Wook Sung5, EunSun Cheong5, Ki-Chul Sung5. 1. Division of Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea. 2. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 3. Sejong General Hospital, Bucheon, Republic of Korea. 4. Department of Internal Medicine, Gangnam CHA Medical Center, CHA University, School of Medicine, Pocheon, Republic of Korea. 5. Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul 110-746, Republic of Korea.
Abstract
AIMS: Inflammation has been suggested to play a role in the pathogenesis of atrial fibrillation (AF). It is uncertain whether C-reactive protein, a robust inflammatory marker, is associated with AF incidence in Asians with lower levels of C-reactive protein compared with western population. This study aimed to determine the association between C-reactive protein and risk of AF in a large population of Koreans. METHODS AND RESULTS: A total of 402 946 Koreans were enrolled in a health screening programme from January 2002 to December 2013. Among them, 210 208 subjects were analysed during the mean follow-up of 4.59 years (1 062 513 person-years). Atrial fibrillation was identified by electrocardiography at every visits. Atrial fibrillation was identified in 561 subjects (0.1%) at baseline. The median (inter-quartile) baseline C-reactive protein levels were higher in subject with AF than in those without AF [0.9 mg/L (0.4-0.9) vs. 0.4 mg/L (0.2-1.0), P < 0.001]. Subjects in the highest quartile of C-reactive protein had more AF than those in the lowest quartile [adjusted odds ratio (OR) 2.02, 95% confidence interval (CI) 1.45-2.81; P< 0.001]. During a mean follow-up of 4.59 years, AF developed in 261 subjects (0.1%). The highest quartile of baseline C-reactive protein had a 1.68-fold (95% CI 1.06-2.67) increased risk of AF than the lowest quartile in multivariate Cox regression analysis. CONCLUSION: Baseline C-reactive protein levels are significantly associated with the prevalence of AF and the risk of AF in Korean populations even C-reactive protein concentrations are substantially lower than reported in white populations. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Inflammation has been suggested to play a role in the pathogenesis of atrial fibrillation (AF). It is uncertain whether C-reactive protein, a robust inflammatory marker, is associated with AF incidence in Asians with lower levels of C-reactive protein compared with western population. This study aimed to determine the association between C-reactive protein and risk of AF in a large population of Koreans. METHODS AND RESULTS: A total of 402 946 Koreans were enrolled in a health screening programme from January 2002 to December 2013. Among them, 210 208 subjects were analysed during the mean follow-up of 4.59 years (1 062 513 person-years). Atrial fibrillation was identified by electrocardiography at every visits. Atrial fibrillation was identified in 561 subjects (0.1%) at baseline. The median (inter-quartile) baseline C-reactive protein levels were higher in subject with AF than in those without AF [0.9 mg/L (0.4-0.9) vs. 0.4 mg/L (0.2-1.0), P < 0.001]. Subjects in the highest quartile of C-reactive protein had more AF than those in the lowest quartile [adjusted odds ratio (OR) 2.02, 95% confidence interval (CI) 1.45-2.81; P< 0.001]. During a mean follow-up of 4.59 years, AF developed in 261 subjects (0.1%). The highest quartile of baseline C-reactive protein had a 1.68-fold (95% CI 1.06-2.67) increased risk of AF than the lowest quartile in multivariate Cox regression analysis. CONCLUSION: Baseline C-reactive protein levels are significantly associated with the prevalence of AF and the risk of AF in Korean populations even C-reactive protein concentrations are substantially lower than reported in white populations. Published on behalf of the European Society of Cardiology. All rights reserved.