Role of C-Reactive Protein for Atrial Fibrillation in Patients with Mitral Stenosis

Structural changes in the atria play an important role in the pathogenesis of AF. Chronic inflammatory processes might cause such changes in the atria of patients with valvular heart diseases and facilitate the occurrence of AF. In this study, we tried to find out whether C-Reactive Protein (CRP), a classical marker for inflammation, is associated with a higher incidence of AF in patients with mitral stenosis. A total of 120 patients with mitral stenosis who were admitted to our institution between years 1996 and 2003 were studied, retrospectively. The rhythm at the time of CRP evaluation was noted for each patient. White blood cell count, erythrocyte sedimentation rate (ESR) and CRP values, risk factors for development of AF, electrocardiographic and echocardiographic findings were recorded as well. Fixty-four of 120 patients were in normal sinus rhythm (Group NSR) and 56 had atrial fibrillation (Group AF). Mean ages of the patients in Group AF were higher than Group NSR (53 ± 11 versus 44 ± 12 yrs, p<0.001). Compared with the Group NSR, Group AF included more men (34 women and 22 men in Group AF vs 54 women and 10 men in Group NSR, p=0.003). White blood cell count and ESR were not different between the groups, while serum CRP levels in Group AF were significantly higher than Group NSR (14.3 ± 12.1 versus 8.1 ± 12.7 mg/l, p=0.007). In multivariate logistic regression only advanced age, left atrium diameter and mitral valve area were independent predictors of AF (p < 0.05). Increased serum CRP levels in patients with AF compared to patients with sinus rhythm, appears to be mediated by age and other correlates and CRP does not seem to be on independent risk factor. (Türk Kardiyol Dern Arş 2004; 32: 350-355)