High sensitivity C reactive protein levels and atrial fibrillation recurrence after catheter ablation for atrial fibrillation: A systematic review and meta-analysis

Surachat Jaroonpipatkul; Angkawipa Trongtorsak; Jakrin Kewcharoen; Sittinun Thangjui; Apichai Pokawattana; Leenhapong Navaravong

doi:10.1002/joa3.12895

High sensitivity C reactive protein levels and atrial fibrillation recurrence after catheter ablation for atrial fibrillation: A systematic review and meta-analysis

J Arrhythm. 2023 Jul 4;39(4):515-522. doi: 10.1002/joa3.12895. eCollection 2023 Aug.

Authors

Surachat Jaroonpipatkul¹, Angkawipa Trongtorsak², Jakrin Kewcharoen³, Sittinun Thangjui⁴, Apichai Pokawattana¹, Leenhapong Navaravong⁵

Affiliations

¹ Division of Cardiology, Rajavithi Hospital Collage of Medicine Rangsit University Bangkok Thailand.
² Department of Cardiovascular Medicine Virginia Commonwealth University Richmond Virginia USA.
³ Division of Cardiovascular Medicine Loma Linda University Health Loma Linda California USA.
⁴ Internal Medicine Residency Program, Bassett Healthcare Network Cooperstown New York USA.
⁵ Division of Cardiology University of Utah Health Salt Lake City Utah USA.

Abstract

Background: Atrial fibrillation (AF) recurrence after AF ablation is not uncommon. High sensitivity C reactive protein (hs-CRP) is a widely used inflammatory marker with a potential property to predict AF recurrence. We conducted a systematic review and a meta-analysis to find an association between hs-CRP levels and AF recurrence after ablation.

Methods: We searched PubMed, Embase, and Wiley-Cochrane Library from inception to January 2022 for studies that reported hs-CRP levels in patients who underwent AF ablation. Weighted mean difference (WMD) was used to evaluate the difference between hs-CRP levels in post-ablation AF recurrent and non-recurrent group. Also, the difference between hs-CRP levels in pre- and post-ablation was determined.

Results: We identified 10 studies, and a total of 789 patients were included (299 recurrent vs. 490 non-recurrent patients). The mean age was 57.7 years (76.4% male). There was no difference in baseline hs-CRP levels between AF recurrent and non-recurrent group (WMD = 0.05, 95% CI = -0.04 to 0.15, p = 0.045). However, higher hs-CRP levels post-ablation were found in AF recurrent group (WMD = 0.09, 95% CI = 0.03-0.15, p < 0.001).

Conclusion: There is no significant difference in baseline hs-CRP levels between AF recurrent and non-recurrent patients after AF ablation. However, higher post-ablation hs-CRP level was found in AF recurrent group. High Sensitivity C reactive protein may play a role as a predictor of AF recurrence.