Hi all – I’m cleaning up some research I had begun a while ago, and now that I’m getting ready for ablation, I’m clearing the computer slate bit by bit.

I have often mused over the possible connection between inflammation as measured by C-reactive Protein (CRP) and afib; I have often wondered which came first – inflammation or afib. The measurement of CRP (serum levels) should be as close to zero as possible – meaning zero inflammation. My baseline 2 years ago was .8 Six months later it was 2.61. With concerted effort taking anti-inflammatory supplements, 4 months later, it was down to 1.13; 3 months later it was 1.0. All this was long after the onset of afib. My afib status had worsened during this same time frame to the point I was put on the antiarrhythmics, Flecanide.

It will be interesting to see if the CCF runs a CRP survey since they are going to prescribe Lipitor to reduce inflammation.

When I was at CCF in April of this year for afib lasting over 24 hours, I had a conversation with the attending MD who had weekend duty. I asked him the question about research and elevated CRP. He said that research was being done about the possible connection and that there was some indication, patients with afib have elevated CRP… but he didn’t know either – which came first.

Following is a report out of the CCF. The conclusion is important to note.


C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation.

Chung MK, Martin DO, Sprecher D, Wazni O, Kanderian A, Carnes CA, Bauer JA, Tchou PJ, Niebauer MJ, Natale A, Van Wagoner DR.

Department of Cardiovascular Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. chungm@ccf.org

BACKGROUND: Atrial fibrillation (AF) may persist due to structural changes in the atria that are promoted by inflammation. C-reactive protein (CRP), a marker of systemic inflammation, predicts cardiovascular events and stroke, a common sequela of AF. We hypothesized that CRP is elevated in patients with atrial arrhythmias.

METHODS AND RESULTS: Using a case-control study design, CRP in 131 patients with atrial arrhythmias was compared with CRP in 71 control patients.

Among arrhythmia patients, 6 had frequent atrial ectopy or tachycardia, 86 had paroxysmal AF, 39 had persistent AF lasting >30 days, and 70 had lone arrhythmias.

CRP was higher in arrhythmia than in control patients (median, 0.21 versus 0.096 mg/dL; P<0.001). Arrhythmia patients in AF within 24 hours before sampling had higher CRP than those in sinus rhythm (0.30 versus 0.15 mg/dL; P<0.001).

CRP in controls was not different than in patients with atrial ectopy or tachycardia. Lone arrhythmia patients had a CRP of 0.21 mg/dL, which was not significantly lower than arrhythmia patients with structural heart disease (CRP, 0.23 mg/dL) but higher than controls (P=0.002).

Persistent AF patients had a higher CRP (0.34 mg/dL) than paroxysmal AF patients (0.18 mg/dL; P=0.008); both groups had higher CRP levels than controls (P
CONCLUSIONS: CRP is elevated in AF patients.

This study is the first to document elevated CRP in non-postoperative arrhythmia patients. These findings are reinforced by stepwise CRP elevation with higher AF burden. Although the cause of elevated CRP levels in AF patients remains unknown, elevated CRP may reflect an inflammatory state that promotes the persistence of AF.
Source:
Circulation. 2001 Dec 11;104(24):2886-91.

For those new to the forum, I’ve copied an excerpt from a post I did a while back on Red Flags or Markers for Heart Disease…. this is the CRP portion. Jackie



C-REACTIVE PROTEIN - is an antibody-like substance and a marker of a future risk of symptomatic peripheral vascular disease and heart disease. It is a protein, and if elevated, indicates arteries are inflamed. Inflammation stimulates white blood cells and can cause cholesterol deposits to break off and clog arteries or weaken instable plaque and trigger a heart attack or stroke.

Elevated C-reactive protein indicates inflammation from trauma, allergy, systemic diseases (rheumatoid arthritis), infection (including pneumonia, herpes, chlamydia and possibly viral infection that simulates a cold.) It is commonly found along with traditional risk factors such as smoking, obesity, high blood lipids, diabetes, hypertension and in victims of acute heart attack and unstable chest pains.

Reference range: .00 - .50 mg/dl… with ideal being as close to zero as possible.

Natural remedies include CoQ10, Beta 1/3/, 1/6 glucan, bromelain, ginger root, ginger tea, curcumin (tumeric). See Hans’ book - the chapter on Stroke Prevention p. 124 and Inflammation p. 130.


Jackie

Jackie,

I had some blood work-up for CRP last week. My reading was 7.5 with the normal high limit being .7 according to my doctor. My lungs felt inflamed from a Bi-Pap machine that I was using for my sleep Apnea which might be the reason for such a high reading. My doctor said he would re-test me in 90 days and if it was still high he would make an effort to find the cause, though he didn't seem confident that he would be successful. He said anything such as a sore throat ect. could be a culprit. I really don't know what to do and hope you might have a suggestion.

Thanks, Don

Don - Well, I'm not a doctor (obviously) just a medical researcher and retired registered dental hygienist with afib and a penchant for finding the cause of afib.

It's true that infections can raise the CRP level. It could even be something like arthritis. Give me a day or so to go back into my research notes for the Red Flags article - I'll try to give you some reference material. In the meantime, just do a Google search. Type in C-reactive protein. There should be alot of info there... but I know I have some specific information in some of the newsletters I receive.

I think 90 days is too long to wait for retesting. But in the meantime, there are an number of natural supplements you can take or even foods to eat that reduce inflammation - the ones that come to mind are ginger - as in ginger tea...made from fresh ginger root. Or bromelain - that comes from pineapple...preferably fresh. Tumeric or curcumin is another but needs to be taken in supplement form - it's difficult to eat enough of this spice on foods unless you really like the taste.

I'll be back soon. Jackie

Jackie,

A few months ago, my CRP was 4, and my GP (here in UK) said this was REALLY LOW! HAving done some reading at the time to ascertain the reference range and units etc., I re-educated him on CRP levels and told him that ONE or less was LOW. I do ponder, however, that since I have for many years now (incl. at the time of the test) had some degree of gastritis and/or esophagitis (GERD), this is what may well elevate my CRP levels - since it is my understanding that ANY inflammation ANYWHERE in the body will increase blood serum CRP levels. WHat do you think??

Mike F.

Jackie and others,

COuld my elevated CRP levels be the result not only of my chronic gastritis, but also my lingering - though mild - candida problems and - a longer shot perhaps - my high bilirubin (Gilbert's Syndrome) levels??

I'm beginning to suspect that in addition to my psychological problems my palps could well be exacerbated by/connected in some way to not only adrenal insufficiency, but also candida/leaky gut/gastritis. I just did some reading which found that continued antacid use promotes the growth of harmful and destructive bacteria in the gut.

Any thoughts on any of the above?

TIA,

Mike F.

Mike - I'm scurring around collecting some great information on this topic... my time is so limited now with ablation looming large here...but this is important stuff...

....inflammation is inflammation, regardles of the source. One book says the majority comes from faulty digestive processes (intestinal) leading to leaky gut syndrome and food allergies...main culprits are the typical dairy and grains. I'll try to excerpt this and hopfully provide some online sources. I believe there is a link to the production of prostaglandins and red meat...but don't quote me until I verify that as well. My memory doesn't always serve accurately.

Inflammation can be just tempory - colds etc... or in Don's case, inflammation from the breathing device.

I gather, though, that it is the chronic or long-standing inflammations (like arthritis - caused by lifestyle) that cause the elevated CRP which leads to heart disease....and most likely contributory to AF if only to the extent that heart cells are irritated and more succeptible to electrical disturbances.

Mike - as you know - any diagnosis ending with the suffix "itis" indicates inflammation.... so gastritis qualifies.

Stay tuned.... I'm getting some info together and will post soon.

Jackie

Here are a few articles - go to these web sites - for basic info on CRP....
I'll be back with some important excerpts from newsletters and books.


Jackie



[www.questdiagnostics.com]

[www.drsinatra.com] - On CRP

[www.mercola.com]

[www.mercola.com]

Mike,

I too have AFIB and Gilbert's Syndrome. I have had both for twenty years.
Any connection?

Newman

Newman,

I've been unable to unearth any correlation research-wise on the net to date. But it is not unreasonable to hypothesise that compromised hepatic function could in some subtle way contribute (for us two at any rate) to ectopy and AF.

I hope all is going well for you post ablation. I sure do like the sound of that second home in Costa Rica!!

Mike F.