Does creatine impact atrial fibrillation?

Introduction

Atrial fibrillation (AF) is a common cardiac arrhythmia that can lead to serious complications such as stroke and heart failure. The potential impact of creatine supplementation on atrial fibrillation is a topic of interest, particularly given the widespread use of creatine among athletes and individuals seeking to enhance physical performance.

Key Insights

Creatine and Atrial Fibrillation Incidence:
- There is a reported case of a young man developing atrial fibrillation potentially linked to creatine monohydrate supplementation, suggesting a possible association between creatine use and the onset of AF in individuals without structural heart disease.
Renal Function and Atrial Fibrillation:
- Reduced creatinine clearance (CrCl) is associated with an increased risk of adverse outcomes, including thromboembolism and all-cause death, in patients with non-valvular atrial fibrillation .
- Lower eGFR and higher urine albumin-to-creatinine ratios are significantly associated with a greater risk of incident atrial fibrillation, indicating that impaired kidney function may contribute to the development of AF.
Creatine Phosphate and Arrhythmias:
- Creatine phosphate has been shown to provide protection against reperfusion-induced arrhythmias in rat heart models, suggesting potential anti-arrhythmic properties.
Creatine Phosphokinase MB and Atrial Fibrillation:
- Elevated postoperative creatine phosphokinase MB levels were not found to predict long-term cardiac death or the development of atrial fibrillation after coronary artery bypass graft surgery.

Conclusion

The available research suggests a potential link between creatine supplementation and the onset of atrial fibrillation, particularly in individuals without pre-existing heart conditions. Additionally, impaired renal function is a significant risk factor for developing atrial fibrillation. While creatine phosphate may have protective effects against certain types of arrhythmias, elevated creatine phosphokinase MB levels do not appear to predict long-term AF outcomes. Further studies are needed to fully understand the mechanisms and implications of creatine use in relation to atrial fibrillation.

Does creatine impact atrial fibrillation?

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Lone Atrial Fibrillation Associated with Creatine Monohydrate Supplementation

Creatine monohydrate supplementation may cause atrial fibrillation in young patients without structural heart disease, highlighting the need for careful patient interviewing and reporting adverse effects.

eGFR and Albuminuria in Relation to Risk of Incident Atrial Fibrillation: A Meta-Analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study.

Reduced eGFR and elevated urine albumin-to-creatinine ratio are significantly associated with increased risk of incident atrial fibrillation.

Impact of creatinine clearance on outcomes in patients with non-valvular atrial fibrillation: a subanalysis of the J-RHYTHM Registry

Lower creatinine clearance levels are an independent predictor of thromboembolism and all-cause death in non-valvular atrial fibrillation patients, with warfarin treatment reducing composite event rates.

Creatine phosphate and protection against reperfusion-induced arrhythmias in the rat heart.

Creatine phosphate effectively protects the rat heart against reperfusion-induced arrhythmias, reducing the incidence of ventricular fibrillation from over 80% to 10%.

Does Creatine Phosphokinase MB Predict Long-Term Cardiac Death or Atrial Fibrillation?

Postoperative creatine phosphokinase MB is not predictive of late cardiac death or atrial fibrillation within 10 years after CABG, but patients with postoperative atrial fibrillation have an increased risk of developing these complications.

Relation of Stroke and Major Bleeding to Creatinine Clearance in Patients With Atrial Fibrillation (from the Fushimi AF Registry).

Japanese patients with atrial fibrillation have a higher risk of stroke/systemic embolism and major bleeding if their creatinine clearance is below 30 ml/min.

Apixaban 5 mg Twice Daily and Clinical Outcomes in Patients With Atrial Fibrillation and Advanced Age, Low Body Weight, or High Creatinine: A Secondary Analysis of a Randomized Clinical Trial.

The 5 mg twice daily dose of apixaban effectively reduces stroke or systemic embolism risk in patients with atrial fibrillation and advanced age, low body weight, or high creatinine levels.

Randomized Trial of Carnitine for the Prevention of Perioperative Atrial Fibrillation.

L-carnitine administration before CABG may reduce the incidence of atrial fibrillation after CABG and reduce inflammation, potentially reducing acute kidney injury.

Atrial contractile dysfunction after short-term atrial fibrillation is reduced by verapamil but increased by BAY K8644.

Verapamil reduces atrial contractile dysfunction after short-term atrial fibrillation, suggesting calcium overload, while BAY K8644 increases it, suggesting atrial ischemia.

Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Atrial fibrillation in the setting of acute myocardial infarction independently predicts increased stroke and 30-day mortality, suggesting more aggressive treatment strategies may be warranted.

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