Predictive value of high sensitivity CRP in patients with diastolic heart failure.
BACKGROUND
C-reactive protein (CRP) has been tested in patients with systolic heart failure (HF) and mixed results have been obtained with regards to its potential predictive value. However, the role of C-reactive protein (CRP) in patients with diastolic HF is not established. We studied the predictive role of high sensitivity CRP (hsCRP) in patients with diastolic HF.


METHODS
HsCRP levels were measured in a cohort of CHF outpatients, 77 patients with diastolic HF and 217 patients with systolic HF. Concentrations were compared to a large cohort of healthy population (n=7701) and associated with the HF admissions and mortality of the patients.


RESULTS
Levels of hsCRP did not differ between patients with systolic and diastolic HF and were significantly elevated compared to the cohort of healthy subjects even after adjustment to various clinical parameters (p<0.0001). In patients with diastolic HF, hsCRP levels associated with New York Heart Association functional class (NYHA-FC) (r=0.31 p=0.01). On univariate Cox regression model hsCRP levels independently predicted hospitalizations in patients with systolic but not diastolic HF (p=0.047).


CONCLUSIONS
HsCRP concentrations are elevated in patients with diastolic HF and correlate with disease severity; their prognostic value in this patient population should be further investigated.
Michowitz
Yoav
Y
The Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Arbel
Yaron
Y
Wexler
Dov
D
Sheps
David
D
Rogowski
Ori
O
Shapira
Itzhak
I
Berliner
Shlomo
S
Keren
Gad
G
George
Jacob
J
Roth
Arie
A
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000145:classification / Q000453:epidemiology; D054143:Heart Failure, Systolic / Q000097:blood / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D003404:Creatinine