26 February 2010
Elevated level of high-sensitivity C-reactive protein is important in determining prognosis in chronic heart failureGuliz KozdagACE, Gokhan ErtasBCDEF, Teoman KilicC, Eser AcarB, Aysen AgirDF, Tayfun SahinF, Metin CetinD, Ulas BildiriciDF, Dilek UralDE
Med Sci Monit 2010; 16(3): CR156-161 :: ID: 878466
While the adverse prognostic impact of a high level of high sensitivity C-reactive protein (hs-CRP) in coronary artery disease is well known, we lack data about the prognostic importance of hs-CRP in chronic heart failure (CHF) patients. The aim was to investigate the relationship between hs-CRP and prognosis in CHF patients.
Material and Method
Patients (n=258, 74 females) with CHF of both ischemic and non-ischemic etiology were followed up for a mean period of 17 + or - 13 months. The primary end-point was cardiac mortality.
During the follow-up period, 71 patients died of cardiac causes. Left ventricular ejection fractions of these patients were lower, but not significantly so (23 + or - 10 vs. 26 + or - 10%, p=0.09). hs-CRP (4.57 + or - 5.35 vs. 1.88 + or - 2.75 mg/dl, p<0.001), brain natriuretic peptide (BNP) (1621 + or - 1361 vs. 736 + or - 914 pg/ml, p<0.001), and creatinine (1.7 + or - 1.7 vs. 1.2 + or - 0.6 mg/dl, p=0.015) levels were significantly higher in CHF patients with cardiac mortality. Using stepwise multivariate Cox proportional hazards regression analyses, hs-CRP proved to be a significant independent predictor of cardiac death (hazard ratio: 1.1, 95%CI: 1.05-1.15, p<0.001).
hs-CRP can provide additional prognostic information for the risk stratification of CHF patients. These insights might ultimately also affect the treatment of CHF patients.
Keywords: Heart Failure - ultrasonography, C-Reactive Protein - metabolism, Aged, 80 and over, Prognosis, Survival Analysis, young adult
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