Significant Increase in C-Reactive Protein and Serum Amyloid A in the Early Hours of Paroxysmal Atrial Fibrillation

A number of data have been accumulated on inflammation in persistent and permanent atrial fibrillation (AF). Our aim was to study the process in paroxysmal AF (PAF) by measuring plasma concentrations of high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA) and fibrinogen in dynamics.

The markers were investigated in 51 patients (26 males and 25 females; 59.84 ± 1.60 years) at hospital admission (baseline), 24 hours and 28 days after sinus rhythm restoration. Fifty-two controls (26 males and 26 females; 59.50 ± 1.46 years) were selected.

At baseline, hs-CRP and SAA concentrations were higher in patients (8.12 ± 0.82 vs. 5.57 ± 0.21 mg/L, P = 0.003; 16.04 ± 0.93 vs. 5.12 ± 0.23 ng/mL, P < 0.001, respectively) and these changes persisted 24 hours after sinus rhythm restoration (8.16 ± 0.71 vs. 5.57 ± 0.21 mg/L, P < 0.001; 12.99 ± 0.75 vs. 5.12 ± 0.23 ng/mL, P < 0.001, respectively). On the 28th day, no significant difference was measured (5.42 ± 0.29 vs. 5.57 ± 0.21 mg/L, P = 0.68; 5.89 ± 0.38 vs. 5.12 ± 0.23 ng/mL, P = 0.08, respectively). At any measurement, fibrinogen levels did not differ between patients and controls (3.30 ± 0.17 vs. 3.22 ± 0.11 g/L, P = 0.70; 3.32 ± 0.11 vs. 3.22 ± 0.11 g/L, P = 0.52; 3.24 ± 0.13 vs. 3.22 ± 0.11 g/L, P = 0.90, respectively).

PAF is associated with dynamics in hs-CRP and SAA plasma levels. The results suggest that inflammation is closely related to the arrhythmia initiation.