New-onset atrial fibrillation in bacteremia is not associated wtih C-reactive protein, but is predictive of increased mortality

Abstract

Abstract Background: Several studies have associated elevated C-reactive protein (CRP) levels to the occurrence of atrial fibrillation (AF). We sought to estimate the frequency and prognostic impact of AF in patients with bacteremia, and to study the possible association between AF and C-reactive protein (CRP) in this population. Materials and Methods: We retrospectively evaluated patient-charts of patients with bacteremia with E.coli or S.pneumoniae admitted to Aker Universitiy Hospital in Oslo throughout the period 1994 to 2004. Variables on known cardiac risk factors for AF, signs of AF, mode of conversion of AF, and, if applicable, date of death, were registered. Initial CRP values were categorized into 4 strata. Odds ratios (ORs) of the 3 highest CRP categories compared with the lowest ones were obtained from logistic models adjusting for known cardiac risk factors for AF. Cox regression analysis was used to compare new-onset AF and death during the first two weeks after hospitalization. Results: 677 patient charts were studied. 104 patients (15.4%) had new-onset AF. Peak incidence of new-onset AF occurred on the day of admission. Peak CRP values were reached during the two next days. High CRP level at admission did not predict the occurrence of AF. The observed mortality was higher among patients with new-onset AF (p=0.04) during the first two weeks after hospitalization. Conclusions: The frequency of new-onset AF in bacteremia is substantial. Initial CRP levels do not predict new-onset AF. In patients with bacteremia, new-onset AF is associated with increased mortality.

Keywords: C-reactive protein / atrial fibrillation / bacteremia / inflammation / arrhythmia / human