TO STUDY THE COMPLICATIONS AND OUTCOMES OF SERUM HIGH SENSITIVITY C-REACTIVE PROTEIN LEVELS & RISK CATEGORIES IN PATIENTS WITH ATRIAL FIBRILLATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 8
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia necessitating hospitalization and associated with significant rates of morbidity and mortality.1 Several haemostatic and inflammatory markers, novel lipid parameters, markers of oxidative stress, and cellular adhesion molecules have been linked to steps in atherogenesis, thrombosis, or cardiovascular disease events like AF.2 But only Serum high sensitivity C-Reactive Protein (Sr. hs-CRP) level and risk category has been shown to add prognostic information over and above that provided by global risk prediction models by the Framingham Risk Score. 3 So screening of Sr. hs-CRP testing appears to be the most promising of AF. The aim of this study was to evaluate the value of Sr. hs-CRP levels and hs-CRP risk categories in patients with AF in predicting Cardio Embolic Ischemic Stroke (CEIS) & other morbidity & mortality. MATERIALS AND METHODS This study was conducted in 86 patients with AF who attended the General Medicine, Cardiology, Neurology OPDs and got admitted in respective wards in M.G.M. Govt. Hospital & K.A.P.V. Govt. Medical College, Thiruchirapalli, Tamilnadu during the period April 2016 to February 2017. RESULTS In this study, of the 86 AF patients, 42 (48.8%) were males and 44 (51.2%) were females with age between 16 and 86 years. Of this Permanent, Persistent, Paroxysmal and Lone AF was detected in 65 (75.58%), 17 (19.77%), 3 (3.49%) and 1 (1.16%) patient with the mean and range of Sr. hs-CRP levels of 4.78 mg/L (1.7 to 9.6), 4.33 mg/L (1.1 to 8.6), 0.8 mg/L (0.7 to 0.9), and 0.9 mg/L (0.9) and with the survival vs expired rate of 22 (33.85%) vs 43 (66.15%), 8 (47.06%) vs 9 (52.94%), 3 (100%) vs 0 (0%) and 1 (100%) vs 0 (0%) respectively. High hs-CRP risk category (> 3 mg/L) was in 65 (75.58%) patients with AF, of which permanent AF in 53 (81.54%) and persistent AF in 12 (18.46%) patients with survival vs expired rate of 13 (24.53%) vs 40 (75.47%) and 4 (33.33%) vs 8 (66.67%) respectively. Average hs-CRP risk category (1 to 3 mg/L) was in 17 (19.77%) AF patients of which permanent AF in 12 (70.59%) & persistent AF in 5 (29.41%) with survival vs Expired rate of 9 (75%) vs 3 (25%) and 4 (80%) vs 1 (20%) respectively. Mild hs-CRP risk category (<1 mg/L) was in 4 AF patients with 100% survival rate of which paroxysmal AF in 3 and Lone AF in 1 patient. In this study, 6 (6.97%) AF patients recovered fully without any complications and 80 (93.02%) AF patients had complications of which Congestive Cardiac Failure (CCF) was in 50 (58.14%), CEIS in 27 (31.39%), Cardiogenic Shock (CGS) in 19 (22.09%), Acute Kidney Injury (AKI) in 3 (3.49%) and Transient Ischemic Attack (TIA) in 2 (2.32%) respectively. CONCLUSION AF patients with high Sr. hs-CRP levels and high hs-CRP risk categories were associated with increased complications and expired rate, whereas mild, average hs-CRP levels and risk categories were associated with less complications & good survival rate. So, Sr. hs-CRP can be considered as a modifiable risk factor and biomarker to predict the mortality and complications in patients with AF.
Authors and Affiliations
Natarajan Ramesh, Sappani Kasipandian
Keywords
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- EP ID EP554974
- DOI 10.14260/jemds/2019/105
- Views 67
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