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Abstract
AF is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function (1). On the electrocardiogram (ECG), AF is characterized by the replacement of consistent P waves by rapid oscillations or fibrillatory waves that vary in amplitude, shape, and timing, associated with an irregular, frequently rapid ventricular response when atrioventricular (AV) conduction is intact (2) (Fig. 1).
Numerous studies from various parts of the world have clearly established that CRP predicts future risk for CVD in apparently healthy persons, independent of established risk factors in the majority of studies. In the studies to date, CRP has been shown to predict myocardial infarction, coronary artery disease (CAD) death, stroke, peripheral arterial disease, sudden death, etc.
CRP levels <1 mg/L were considered low-risk, 1 to 3 mg/L as average risk, and >3 mg/L as high-risk for CVD (Table 1). With regard to risk assessment, if the value on 2 occasions 1month apart is in the same category, ie: <1, 1 to 3, and 3 to 10 mg/L, this can be taken as reliable evidence with regard to low, average, and high risk for subsequent CVD. However, if the CRP level is >10 mg/L, then CRP cannot be used to assess cardiovascular risk and other active inflammatory processes (eg: trauma, infection, etc) should be excluded. Thus, when using CRP to assess cardiovascular risk in primary prevention, one needs to adopt the high sensitive (Hs-CRP) assay, and the patient should be free from any kind of acute inflammation such as infection, trauma, etc, for at least 2 weeks (61, 62, 63).