Elevated level of high-sensitivity C-reactive protein is important in determining prognosis in chronic heart failure.
BACKGROUND
While the adverse prognostic impact of a high level of high sensitivity C-reactive protein (hs-CRP) in coronary artery disease is well known, we lack data about the prognostic importance of hs-CRP in chronic heart failure (CHF) patients. The aim was to investigate the relationship between hs-CRP and prognosis in CHF patients.


METHODS
Patients (n=258, 74 females) with CHF of both ischemic and non-ischemic etiology were followed up for a mean period of 17 + or - 13 months. The primary end-point was cardiac mortality.


RESULTS
During the follow-up period, 71 patients died of cardiac causes. Left ventricular ejection fractions of these patients were lower, but not significantly so (23 + or - 10 vs. 26 + or - 10%, p=0.09). hs-CRP (4.57 + or - 5.35 vs. 1.88 + or - 2.75 mg/dl, p<0.001), brain natriuretic peptide (BNP) (1621 + or - 1361 vs. 736 + or - 914 pg/ml, p<0.001), and creatinine (1.7 + or - 1.7 vs. 1.2 + or - 0.6 mg/dl, p=0.015) levels were significantly higher in CHF patients with cardiac mortality. Using stepwise multivariate Cox proportional hazards regression analyses, hs-CRP proved to be a significant independent predictor of cardiac death (hazard ratio: 1.1, 95%CI: 1.05-1.15, p<0.001).


CONCLUSIONS
hs-CRP can provide additional prognostic information for the risk stratification of CHF patients. These insights might ultimately also affect the treatment of CHF patients.
Kozdağ
Güliz
G
Kocaeli University, Medical Faculty, Department of Cardiology, Kocaeli, Turkey.
Ertaş
Gökhan
G
Kiliç
Teoman
T
Acar
Eser
E
Ağir
Ayşen
A
Sahin
Tayfun
T
Cetin
Metin
M
Bildirici
Ulaş
U
Ural
Dilek
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D014463:Ultrasonography; D055815:Young Adult
D002097:C-Reactive Protein