title: Role of plasma C-reactive protein and white blood cell count in predicting in-hospital clinical events of acute type A aortic dissection.
abstract: BACKGROUND
  A few recent studies have reported that inflammation is associated with the prognosis of acute aortic dissection (AD). There is, however, no systemic investigation regarding the role of plasma C-reactive protein (CRP) and white blood cell (WBC) levels in predicting in-hospital clinical events of acute type A AD.
  
  
  METHODS
  The levels of high-sensitivity CRP and WBC counts were systemically determined after admission in 36 patients with acute type A AD. The variations of plasma CRP and WBC levels in different time windows (admission, 1, 2, 3, 4, 6, 8 days) in patients with acute type A AD were analyzed between patients with events and without events.
  
  
  RESULTS
  During hospitalization, five patients died, and increased levels of CRP and WBC were found in patients died with acute type A AD compared with patients survived (P < 0.01, respectively). Medical treatment may significantly decrease inflammatory response in survived patients with acute type A AD. Additionally, patients with complication of pleural effusion showed higher CRP and WBC levels (P = 0.046, P = 0.018, respectively). Lower WBC levels were found in survived patients treated medically (P = 0.001). Moreover, mean CRP and WBC levels had positive correlations with aortic diameter (r = 0.364, P = 0.000; r = 0.333, P = 0.000, respectively) and age (r = 0.270, P = 0.000, respectively), while negative correlations with the time from onset of symptoms to hospital admission (r = -0.229, P = 0.000, r = -0.200, P = 0.002, respectively). Univariate analysis showed that age ≥ 65 years, CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm, pleural effusion and diastolic blood pressure ≥ 105 mmHg were associated with hospital mortality. While CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm were strongly associated with hospital mortality in multiple Logistic regression analysis.
  
  
  CONCLUSIONS
  The results suggested that CRP and WBC were preferred markers for predicting the clinical events in patients with acute type A AD, especially death during hospitalization. Therefore, further study enrolling larger cohort, prospective study would be warranted.
authors: Hypertension Division, Fu Wai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
authors: Dan
authors: D
authors: Wen
authors: Hai-ying
authors: HY
authors: Wu
authors: Xiong-jing
authors: XJ
authors: Jiang
authors: Hui-min
authors: HM
authors: Zhang
authors: Xian-liang
authors: XL
authors: Zhou
authors: Jian-jun
authors: JJ
authors: Li
authors: Ru-tai
authors: RT
authors: Hui
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000097:blood* / Q000175:diagnosis*; D017545:Aortic Aneurysm, Thoracic / Q000097:blood* / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
chemical_list: D002097:C-Reactive Protein