Underlying Inflammation in Current Smokers or Obese Subjects May Be Responsible for Concomitant, Drug-Resistant Atrial Fibrillation

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Background: Recent studies have suggested the close interrelationship between the inflammation and genesis and/or maintenance of atrial fibrillation (AF). However, it still remains unclear what is the significant factors contributing to the inflammatory condition in AF patients. Methods: 421 patients with drug-resistant AF were included and divided into 2 groups according to the baseline high-sensitive C-reactive protein (hs-CRP) level. A multivariable logistic model was constructed to predict the parameters responsible for the inflammatory condition in AF patients. Results: The median baseline hs-CRP level was 0.07 mg/dL and the prevalence of patients with BMI >25 kg/m2 (p<0.001), chronic kidney disease (eGFR <60 ml/min/1.73 m2; p<0.05), and current smoking within 1 month (p<0.01) were greater in patients with higher hs-CRP levels (>0.08; n=191), than those with lower hs-CRP levels (p<0.07; n=230). A multivariable logistic analysis revealed that a BMI>25 (OR=1.99 [1.32–3.01], p<0.01) and current smoking (OR=2.22 [1.28–3.87], p<0.01) were independently associated with the higher hs-CRP levels. Conclusions: The inflammatory condition in AF patients was associated with the BMI and smoking habitat. A body weight reduction and quit smoking may improve the inflammation state, which might improve the AF occurrences and status in those patients.