title: C-reactive protein in acute pulmonary embolism.
abstract: BACKGROUND
  Right ventricular dysfunction and N-terminal proB-type natriuretic peptide (NT-proBNP) are established determinants of prognosis in acute pulmonary embolism (PE). The aim of the study was to investigate the prognostic value of C-reactive protein (CRP) in PE.
  
  
  METHODS
  Fifty-six patients (mean age, 64.4 T 14.8years; 22 male subjects) with acute PE were consecutively enrolled and followed for 36 months after discharge. Serum CRP, NT-proBNP, and troponin T levels were determined. Right ventricular function was evaluated by transthoracic echocardiography.
  
  
  RESULTS
  Right ventricular dysfunction was present in 31 patients and was more frequent in patients with higher CRP and NT-proBNP levels (P = 0.020 and P = 0.045, respectively). During the 36-month follow-up, there were 15 terminal events (death due to recurrent PE). The mortality rate was 41.2% in patients with NT-proBNP levels greater than 1000 pg/mL, whereas it was 5.9% in patients with less than 500 pg/mL (P = 0.011). Mortality rates also were higher in patients with elevated CRP and troponin T levels, but the differences did not reach clinical significance. The survival rate of acute PE patients with lower NT-proBNP and CRP levels was better than that of patients with higher NT-proBNP and CRP levels. Receiver operating characteristic curve analysis demonstrated cutoff values for NT-proBNP as 1800 pg/mL (sensitivity, 93.3%; specificity, 68.2%; positive predictive values, 66.7%; and negative predictive values, 93.8%) and for CRP as 48 mg/L (sensitivity, 72.7%; specificity, 61.9%; positive predictive values, 50.0%; and negative predictive values, 81.3%) to predict mortality in PE patients.
  
  
  CONCLUSIONS
  C-reactive protein is associated with right ventricular dysfunction, which is a predictor of prognosis in PE and may become a promising biomarker for risk stratification of PE, although CRP is not found superior to NT-proBNP.
authors.affiliation: Ministry of Health Bismil Government Hospital, Pulmonary Medicine Clinics, Diyarbakir, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Abul
authors.forename: Sait
authors.initials: S
authors.lastname: Karakurt
authors.forename: Beste
authors.initials: B
authors.lastname: Ozben
authors.forename: Ahmet
authors.initials: A
authors.lastname: Toprak
authors.forename: Turgay
authors.initials: T
authors.lastname: Celikel
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010343:Patient Admission; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D020107:Troponin T / Q000097:blood; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000150:complications / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein