title: Elevated levels of plasma C-reactive protein are associated with decreased graft survival in cardiac transplant recipients.
abstract: BACKGROUND
  Inflammation may be involved in the origin of transplant coronary artery disease. We hypothesized that plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6), markers for systemic inflammation, would correlate with cardiac transplant graft survival.
  
  
  RESULTS
  We studied 99 consecutive cardiac transplant recipients who were referred for routine endomyocardial biopsy and/or surveillance coronary angiography. Plasma levels of CRP and IL-6 were measured by their respective ELISAs. Patients were divided into 2 groups: those who died or required retransplantation and those who survived without the need for retransplantation. During the follow-up period of 5.0+/-2.7 years (range, 0.2 to 15.1 years) after transplant, 20 patients died and 9 required retransplantation. There was no significant difference in age, race, sex, cause of native myopathy, presence of diabetes, or use of aspirin, statins, or calcium channel blockers between the 2 groups. Although IL-6 did not relate to graft failure, CRP level was predictive of allograft failure (P:=0.003). The risk of allograft failure increased 36% for every 2-fold increase in CRP level. Moreover, CRP levels also correlated significantly with the frequency of grade 3 rejection (P:=0.02). In multivariate analysis, when combined with other significant predictors such as donor age and sex mismatching of the graft, CRP still significantly predicted graft failure (P:=0.025) with a 32% increase in the risk of graft failure for every 2-fold increase in CRP level.
  
  
  CONCLUSIONS
  These findings suggest that elevated plasma levels of CRP are associated with subsequent allograft failure in cardiac transplant recipients.
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Eisenberg
authors.forename: H J
authors.initials: HJ
authors.lastname: Chen
authors.forename: M K
authors.initials: MK
authors.lastname: Warshofsky
authors.forename: R R
authors.initials: RR
authors.lastname: Sciacca
authors.forename: H S
authors.initials: HS
authors.lastname: Wasserman
authors.forename: A
authors.initials: A
authors.lastname: Schwartz
authors.forename: L E
authors.initials: LE
authors.lastname: Rabbani
mesh_terms: D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006085:Graft Survival; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein