title: Elevated level of high-sensitivity C-reactive protein is important in determining prognosis in chronic heart failure.
abstract: 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.
authors.affiliation: Kocaeli University, Medical Faculty, Department of Cardiology, Kocaeli, Turkey.
authors.forename: Güliz
authors.initials: G
authors.lastname: Kozdağ
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ertaş
authors.forename: Teoman
authors.initials: T
authors.lastname: Kiliç
authors.forename: Eser
authors.initials: E
authors.lastname: Acar
authors.forename: Ayşen
authors.initials: A
authors.lastname: Ağir
authors.forename: Tayfun
authors.initials: T
authors.lastname: Sahin
authors.forename: Metin
authors.initials: M
authors.lastname: Cetin
authors.forename: Ulaş
authors.initials: U
authors.lastname: Bildirici
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
mesh_terms: 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
chemical_list: D002097:C-Reactive Protein