1. Association of inflammatory factors with occurrence and recurrence of atrial fibrillation: A meta-analysis
- Author
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Shifei Tong, Li Zhong, Long Wu, Zhiyuan Song, Xiangyu Ma, Yafei Li, Bin Xu, Na Wu, Ying Xiang, Maoqing Shu, and Yao Zhang
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Population ,Catheter ablation ,Subgroup analysis ,Recurrence ,White blood cell ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,education ,education.field_of_study ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,business.industry ,Interleukin-8 ,Atrial fibrillation ,medicine.disease ,Confidence interval ,Observational Studies as Topic ,C-Reactive Protein ,medicine.anatomical_structure ,Strictly standardized mean difference ,Meta-analysis ,Cardiology ,Inflammation Mediators ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Background The role of circulating inflammatory factors in atrial fibrillation (AF) occurrence and recurrence remains inconclusive. Methods We conducted a meta-analysis of observational studies evaluating the association of inflammatory factors with AF risk, postoperative AF (POAF) occurrence after coronary artery bypass grafting (CABG) surgery, and AF recurrence after electrical cardioversion (EC) or catheter ablation. Results Increased C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α were significantly associated with AF risk (standardized mean difference [SMD] [95% confidence interval (CI)]: 0.95 [0.72–1.18], 0.89 [0.64–1.15] and 2.20 [1.17–3.23], respectively). In subgroup analysis, CRP was significantly associated with persistent and permanent AF risk, but not with paroxysmal AF. Increased preoperative CRP and IL-6 were associated with greater risk of post-CABG AF (SMD [95% CI]: 0.28 [0.02–0.54] and 1.03 [0.03–2.04], respectively). Consistent significant associations between CRP and AF recurrence were found in both patient subgroups who underwent EC (SMD, 0.56; 95% CI, 0.36–0.76) and ablation (SMD, 0.48; 95% CI, 0.11–0.86). IL-6 was significantly associated with AF recurrence after ablation (SMD, 0.55; 95% CI, 0.25–0.85), but not with the recurrence after EC (SMD, 0.85; 95% CI, −0.26–1.95). Conclusion Increased circulating inflammatory factors, such as CRP and IL-6, are associated with greater AF risk in general population and patients who underwent CABG, as well as with AF recurrence after EC or ablation. Future research is warranted to elucidate the roles of other inflammatory markers, such as white blood cell, IL-8, and transforming growth factor-β1, in occurrence and recurrence of well-established different clinical subtypes of AF.
- Published
- 2013
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