C-Reactive Protein and the Risk of Atrial Fibrillation: A Systematic Review and Meta-Analysis

Citation : Venkata M Alla, Senthil Thambidorai, Kishlay Anand, Aryan N Mooss, Richard Baltaro, Syed M Mohiuddin.C-Reactive Protein and the Risk of Atrial Fibrillation: A Systematic Review and Meta-Analysis .JAFIB.2010 January;Volume 1 Issue(10): 569-579.

There is increasing evidence linking C-reactive protein (CRP) and atrial fibrillation (AF). Despite the abundance of literature, confusion exists regarding this association because of inconsistent results. MEDLINE and Cochrane Controlled Trials Register databases were carefully searched through July, 2007 combining the following terms “C-reactive protein” and “atrial fibrillation”. Of the 106 studies initially identified, 7 studies with 7349 subjects (638 with AF) were included in the meta-analysis. Analysis yielded a relative risk of 1.51 (1.24, 1.84) for occurrence of AF when CRP level was above a cut off of 3-3.5 mg/l. When 2 studies with data on a higher cut off of 4.5-5.0 mg/l were analyzed separately, the relative risk was 4.03 (2.6, 6.2). Our study suggests that elevated CRP increases the relative risk for AF. The risk appears incremental with higher CRP levels conferring proportionately increased risk. There is an urgent need for further large scale well designed studies.