Detalle Publicación


Usefulness of High-Sensitivity C-Reactive Protein to Predict Mortality in Patients With Atrial Fibrillation (from the Atherosclerosis Risk In Communities [ARIC] Study)

Autores: Hermida Santos, José María (Autor de correspondencia); Lopez, F. L.; Montes, R. ; Matsushita, K. ; Astor, B. C. ; Alonso Gutiérrez, Álvaro
ISSN: 0002-9149
Volumen: 109
Número: 1
Páginas: 95 - 99
Fecha de publicación: 2012
High-sensitivity C-reactive protein (hs-CRP) is a marker for the risk of cardiovascular and overall mortality. However, information about the association between hs-CRP and mortality in patients with atrial fibrillation is scarce. A total of 293 participants of the Atherosclerosis Risk In Communities study with a history of AF and hs-CRP levels available were studied. During a median follow-up of 9.4 years, 134 participants died (46%). The hazard ratio of all-cause mortality associated with the highest versus the lowest tertile of hs-CRP was 2.52 (95% confidence interval 1.49 to 4.25) after adjusting for age, gender, history of cardiovascular diseases, and cardiovascular risk factors. A similar trend was observed for cardiovascular mortality (57 events; hazard ratio 1.90, 95% confidence interval 0.81 to 4.45). The Congestive heart failure, Hypertension, Age >75 years, Diabetes, and previous Stroke or transient ischemic attack (CHADS2) score was also associated with all-cause and cardiovascular mortality, with an adjusted hazard ratio of 3.39 (95% confidence interval 1.91 to 6.01) and 8.71 (95% confidence interval 2.98 to 25.47), respectively, comparing those with a CHADS2 score >2 versus a CHADS2 score of 0. Adding hs-CRP to a predictive model including the CHADS2 score was associated with an improvement of the C-statistic for total mortality (from 0.627 to 0.677) and for cardiovascular mortality (from 0.700 to 0.718). In conclusion, high levels of hs-CRP constitute an independent marker for the risk of mortality in patients with atrial fibrillation. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;109:95-99)