title: C-reactive protein predicts functional status and correlates with left ventricular ejection fraction in patients with chronic stable angina.
abstract: C-reactive protein (CRP) is a marker for cardiovascular risk but may also participate in the pathogenesis of atherosclerosis and myocardial injury. We sought to investigate the relationship among CRP, left ventricular ejection fraction (LVEF) and symptoms of congestive heart failure (CHF) in patients with chronic stable angina (CSA) pectoris.
  
  
  METHODS
  We studied 841 patients (63+/-10 years, 72% men) with CSA undergoing coronary angiography. Symptoms of CHF were assessed using the New York Heart Association (NYHA) functional classification. CRP measurements were performed using a high sensitivity (hs-) immunoassay at the time of diagnostic coronary angiography.
  
  
  RESULTS
  Baseline serum hs-CRP levels showed a significant correlation with LVEF (r=-0.11; P=0.004), and prevalence of moderate-to-severe CHF correlated with serum hs-CRP quartiles (P(trend)<0.0001). After adjustment, age (P=0.004), female gender (P=0.03), body mass index (P<0.0001) and hs-CRP (OR 2.2 [1.3-3.6] CI 95%; P=0.002) were independent predictors of NYHA functional classes III-IV irrespective of LVEF and angiographic severity of CAD. A CRP value of 3.2mg/L had a sensitivity of 72%, a specificity of 75%, and a negative predictive value of 96% for detecting an impaired functional class.
  
  
  CONCLUSIONS
  Hs-CRP serum concentrations showed an inverse correlation with LVEF and were an independent predictor of NYHA functional class in patients with CSA.
authors.affiliation: Division of Cardiology, Hospital General Universitario, Guadalajara, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Arroyo-Espliguero
authors.forename: Pablo
authors.initials: P
authors.lastname: Avanzas
authors.forename: Juan
authors.initials: J
authors.lastname: Quiles
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Kaski
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000097:blood*; D002097:C-Reactive Protein / Q000096:biosynthesis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis; D002908:Chronic Disease; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000097:blood*; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D002097:C-Reactive Protein