C-reactive protein: an inflammatory marker with prognostic value in patients with decompensated heart failure.
BACKGROUND
Inflammation has been implicated in the pathophysiology of a series of cardiovascular diseases. C-reactive protein (CRP) is a marker of inflammation easily obtained in the emergency room.


OBJECTIVE
To study the prognostic value of CRP in patients admitted for acute decompensated heart failure (ADHF).


METHODS
A prospective cohort of 119 patients with ADHF treated in the emergency room. Mean age was 74+/-11 years and 76 (64%) of patients were male. All were New York Heart Association Functional Class III or IV. CRP was measured by nephelometry at admission. Patients were followed after hospital discharge for an average of 12+/-9.7 months and cardiovascular mortality was the outcome analyzed.


RESULTS
There were 44 (36.9%) deaths, all from cardiovascular causes. Individuals with CRP > 3 mg/dl had higher mortality than those below this level (p=0.018). In the multivariate analysis using Cox proportional model, CRP proved to be the most important independent prognostic factor (odds ratio 0.0916 [95% CI = 0.0341 - 0.1490] for each one-unit increment in CRP).


CONCLUSIONS
CRP is an independent cardiovascular mortality predictor in patients with ADHF, indicating that inflammation represents an important component in the pathophysiology of the disease.
Villacorta
Humberto
H
Universidade Federal Fluminense, Faculdade de Ciências Médicas, Niterói, RJ, Brazil. hyvillacorta@globo.com
Masetto
Antonio Claudio
AC
Mesquita
Evandro Tinoco
ET
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis
D015415:Biomarkers; D002097:C-Reactive Protein