Abstract
PURPOSE: Chronic low-grade inflammation is increasingly recognized as a contributing factor in the development of cardiovascular events. This study aimed to evaluate the association between time-weighted cumulative exposure to high-sensitivity C-reactive protein (cumhsCRP) and the risk of new-onset cardiac conduction block (CCB). PATIENTS AND METHODS: A total of 48,703 participants from a prospective community-based cohort were included. The average exposure time for cumhsCRP was 6.36 years. Participants were stratified into two groups: cumhsCRP < 2 mg/L and cumhsCRP ≥ 2 mg/L. The incidence of new-onset cardiac conduction block and its subtypes was identified through standard 12-lead electrocardiograms. Cox proportional hazards models were used to assess the relationship between cumhsCRP levels and incident CCB risk, adjusting for potential confounders. A restricted cubic spline curve further explored the dose-response pattern. RESULTS: During a mean follow-up period of 9.24 years, 803 cases of new-onset CCB were documented (incidence rate: 1.65%). After full multivariable adjustment, individuals in the cumhsCRP ≥ 2 mg/L group exhibited a significantly higher risk of CCB compared to those with cumhsCRP < 2 mg/L (HR: 1.24, 95% CI: 1.07-1.44). The RCS analysis suggested a linear association between log-transformed cumhsCRP and CCB risk (p for non-linearity = 0.294). CONCLUSION: Elevated cumulative exposure to high-sensitivity C-reactive protein is independently associated with an increased risk of developing CCB, especially left bundle branch block and left anterior fascicular block. This study will provide new insights into the prevention of CCB.