title: C-reactive protein elevation independently influences the procedural success of percutaneous balloon mitral valve commissurotomy.
abstract: BACKGROUND
  Markers of systemic inflammation including C-reactive protein (CRP) appear to predict morbidity and mortality in various clinical conditions. The presence of systemic inflammation and its impact on the procedural success of percutaneous balloon mitral valve commissurotomy (PBMC) in patients with rheumatic mitral stenosis has not been previously demonstrated.
  
  
  METHODS
  Measurements of CRP with a high-sensitivity assay were performed at the time of PBMC or during post-procedural follow-up in 119 patients with mitral stenosis of rheumatic morphology. Patients were questioned to exclude confounders of CRP elevation and categorized into undetectable (< or =0.10 mg/L) and detectable (>0.10 mg/L) CRP levels. Detectable levels were further classified into assay range (>0.10 and < or =6.0 mg/L) and elevated (>6.0 mg/L).
  
  
  RESULTS
  CRP was detectable in 76% of patients and elevated (>6.0 mg/L) in 36% of patients studied. Procedural success occurred in 89% of patients with undetectable CRP, as compared with only 67% in patients with detectable CRP (P =.028). This effect remained after controlling for age and valve score (previously described predictors of PBMC success).
  
  
  CONCLUSIONS
  Systemic inflammation is common in patients with rheumatic mitral valve stenosis, and the relationship between procedural success and CRP suggests persistent inflammation may affect the results of PBMC.
authors.affiliation: Division of Cardiology, Wilford Hall Medical Center, United States Air Force, Lackland AFB, Tex 78236-5300, USA. richard.krasuski@lackland.af.mil
authors.forename: Richard A
authors.initials: RA
authors.lastname: Krasuski
authors.forename: Anneke
authors.initials: A
authors.lastname: Bush
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kay
authors.forename: Charles E
authors.initials: CE
authors.lastname: Mayes
authors.forename: Andrew
authors.initials: A
authors.lastname: Wang
authors.forename: Judy
authors.initials: J
authors.lastname: Fleming
authors.forename: Cynthia
authors.initials: C
authors.lastname: Pierce
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Kisslo
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Harrison
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Bashore
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D012214:Rheumatic Heart Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D013223:Statistics as Topic; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein