Effect of C-reactive protein reduction on paroxysmal atrial fibrillation

C-reactive protein (CRP) lowering is associated with a reduction in recurrent and permanent atrial fibrillation. This study sought to determine whether CRP lowering also results in a reduction of paroxysmal atrial fibrillation (PAF) during daily life.

We enrolled 80 patients with proven PAF, CRP between 0.8 and 13 mg/L, and at least 1 episode of PAF on ambulatory electrocardiographic monitoring. Forty patients were randomized to placebo (placebo group) and 40 to atorvastatin (treatment group). Plasma CRP levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The 2 groups were comparable with respect to baseline characteristics, number of episodes of PAF, and baseline plasma CRP levels. The treatment group had lower median CRP levels at study end and experienced a significant reduction in the number of episodes of PAF compared with the placebo group. Paroxysmal atrial fibrillation was completely resolved in 26 (65%) of 40 patients in the treatment group versus 4 (10%) of 40 in the placebo group. The treatment group exhibited a highly significant reduction in PAF (P < .001). By logistic regression, treatment with atorvastatin was an independent predictor of PAF resolution.

C-reactive protein lowering with atorvastatin appears to be effective in eliminating PAF during daily life in a significant proportion of patients.