[C-reactive protein and atrial fibrillation. An old marker looking for a new target].

The prevalence and clinical impact of atrial fibrillation (AF), the most common cardiac rhythm disturbance, continues to increase. The pathophysiology of AF is still not well understood and it is generally accepted that the majority of cases are due to fibrosis or degeneration of the atrial muscle, sinus node disease or conduction abnormalities, or to the underlying heart disease itself or ageing. In recent years, a large volume of information has been published on the role of Creactive protein (CRP) as a predictor of vascular events in cardiovascular disease1-3 and attempts have been made to identify variables that increase or decrease the levels of this inflammatory marker. Elevated CRP levels has been identified as a prognostic marker in healthy individuals and in patients with stable or unstable angina, following myocardial infarction, or after cardiac arrest. The possibility that the association of inflammation with AF could be demonstrated with the help of CRP has recently captured the attention of many researchers. Histologic studies, such as that of Frustaci et al,4 have demonstrated that inflammatory infiltrates are present in biopsies from patients with lone AF but absent in control subjects. Likewise, various epidemiologic studies have demonstrated an association between CRP concentration and AF.5 Case-controlled studies have shown a correlation between CRP and the outcome of cardioversion.6 Additional data is now provided in an article by Zarauza et al7 published in this issue of REVISTA ESPAÑOLA DE CARDIOLOGÍA. C-Reactive Protein and Atrial Fibrillation. An Old Marker Looking for of a New Target