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Journal of the American College of Cardiology

Clinical Articles, Lead Article

Role of inflammatory markers in AF under scrutiny

Inflammation seems to play an important role in the prothrombotic state associated with atrial fibrillation (AF), according to a study1 published recently in the Journal of the American College of Cardiology.

Researchers searched PubMed databases between January 1990 and December 2011 with the following terms individually or in combination: “atrial fibrillation,” “inflammation,” “interleukin,” “chemokine,” “IL-2,” “IL-6,” “IL-8,” “CRP,” “TNF- a,” “MCP-1,” and “prothrombotic state.” References from the relevant articles were reviewed, and related articles were identified.

They found that inflammatory markers measured in peripheral blood seemed to correlate well with clinical and echocardiographic risk factors of thromboembolism. They suggested that their clinical-research data could be translated into clinical practice in the risk stratification of AF, and inflammatory biomarkers could potentially refine clinical risk stratification for stroke and thromboembolism.

However, both the sample sizes and the effect sizes reported in available studies do not support the routine clinical use of inflammatory biomarkers in AF management, the authors said. Few studies have assessed the importance of inflammatory biomarkers in predicting directly hard endpoints such as stroke and mortality, they added, calling for further studies with large sample sizes and hard endpoints to assess the clinical importance of inflammatory biomarkers in AF.

Figure 1. Proposed Mechanism Linking Inflammation and Thrombosis in AF

Figure 1. Proposed mechanism linking inflammation and thrombosis in AF


1. Guo Y, Lip GYH, Apostolakis S. Inflammation in atrial fibrillation. J Am Coll Cardiol 2012;60:2263–70.

Published on: December 20, 2012

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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