Journal
AMERICAN JOURNAL OF CARDIOLOGY
Volume 109, Issue 1, Pages 95-99Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2011.08.010
Keywords
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Categories
Funding
- CIMA
- Instituto de Salud Carlos III [PI081349]
- Red Tematica de Investigacion, and Health Department, Gobierno de Navarra [RD06/0014/0008, 15/09]
- National Heart, Lung, and Blood Institute (Bethesda, Maryland) [HHSN268201100005C, HHSN268201100006C, HHSN 268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN 268201100010C, HHSN268201100011C, HHSN268201100012C, RC1-HL099452]
- American Heart Association (Rockland, Maryland) [09SDG 2280087]
- National Institute of Diabetes and Digestive and Kidney Diseases (Bethesda, Maryland) [R01-DK076770]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [RC1HL099452] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK076770] Funding Source: NIH RePORTER
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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)
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