State-of-the-Art Paper
Inflammation in Atrial Fibrillation

https://doi.org/10.1016/j.jacc.2012.04.063Get rights and content
Under an Elsevier user license
open archive

Atrial fibrillation (AF) is associated with increased risk for stroke and systemic embolism. There is plausible evidence linking inflammation to the initiation and perpetuation of AF and AF-related thrombosis. Various inflammatory markers (C-reactive protein, tumor necrosis factor-α, interleukin-2, interleukin-6, and interleukin-8) have been associated with AF. Proposed mechanisms linking inflammation and the prothrombotic AF state include endothelial activation/damage, production of tissue factor from monocytes, increased platelet activation, and increased expression of fibrinogen. The present review aims to provide an update on the association of inflammation and AF, including the impact of inflammatory markers on clinical presentation and outcome of AF patients.

Key Words

atrial fibrillation
inflammation
prothrombotic state

Abbreviations and Acronyms

AF
atrial fibrillation
CABG
coronary artery bypass graft
CRP
C-reactive protein
IL
interleukin
MCP
monocyte-chemoattractant protein
MNC
mononuclear cell
sCD40L
soluble CD40L
TF
tissue factor
TNF
tumor necrosis factor
vWF
von Willebrand factor

Cited by (0)

Drs. Apostolakis and Lip have received research funding and honoraria from various pharmaceutical companies in relation to atrial fibrillation for meetings and educational symposia. Dr. Lip has served as a consultant for Bayer, Astellas, Merck, AstraZeneca, Sanofi, BMS/Pfizer, Daiichi-Sankyo, Biotronik, Portola, and Boehringer Ingelheim; has been on the speaker's bureau for Bayer, BMS/Pfizer, Boehringer Ingelheim, and Sanofi Aventis; is a member of advisory boards and trial steering committees; he was clinical advisor to the UK National NICE Guidelines on Atrial Fibrillation Management; and was on the writing group for the European Society of Cardiology Guidelines on Atrial Fibrillation Management; he is also a panelist on the revised (9th edition) American College of Chest Physicians Guidelines on Antithrombotic Therapy. Dr. Guo has reported that he has no relationships relevant to the contents of this paper to disclose.