C-REACTIVE PROTEIN: A NEW MARKER OF ARRHYTHMIC …
C-REACTIVE PROTEIN: A NEW MARKER OF ARRHYTHMIC EVENT IN BRUGADA SYNDROME?
A. Bonny1, F. Larrazet2, I. Ditah3, F. Hidden-Lucet4, G. Fontaine4, R. Frank4
1Hopital Saint Camille, Bry Sur Marne, France, 2Hopital Saint Camille, Bry Sur Marne, France, 3Wayne State University, Department of Medicine, Detroit, MI, USA, 4Hopital Pitie Salpetriere, Unite De Rythmologie, Paris, France
Background: Inflammatory pathway of Brugada syndrome (BrS) has been little studied, although an increasing body of evidence links lethal ventricular arrhythmias and inflammatory states. Methods and Results: Fifty four patients with BrS were screened in our centre. According to current guidelines, all patients underwent physical examination and detailed cardiac tests. At admission, prior to any intervention (e.g electrophysiological study and Implantable cardioverter-defibrillator (ICD) implantation), all patients had blood samples drawn for CRP levels. Physicians deciding to implant an ICD according to current guidelines were blinded to CRP concentrations. Patients with febrile state or evidence of infection were excluded. We divided our study group in to two groups: symptomatic (syncope or aborted sudden death) and asymptomatic. In our multivariable analysis, we adjusted for significant variables (hypertension, history of VT, decision to implant an ICD). The mean age was 45±13 years, and 91% were male. Twenty (37%) were symptomatic (17 syncopes and 3 aborted SCD). Baseline characteristics were similar in both groups. Mean CRP level was 2,4±1,42mg/l in symptomatic group and 1,41±0,92mg/l in asymptomatic group (P=0.03). In a multivariate model, CRP concentrations ≥2 mg/l remained an independent marker for being symptomatic (P=0.004; 95% CI: 1.8 to 21.7) and a predictor of ICD implantation (P=0.008; 95% CI: 2.2 to 19.8). Conclusion: C-reactive protein is significantly higher in symptomatic patients with Brugada syndrome. CRP concentrations ≥ 2 mg/l seem to be a biomarker for cardiac events in high risk patients with Brugada syndrome. Larger trials are needed to confirm these findings.
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