title: High sensitivity C-reactive protein and cardfiac resynchronization therapy in patients with advanced heart failure.
abstract: BACKGROUND
  The data on the prognostic values of high sensitivity C-reactive protein (hsCRP) levels in patients with advanced symptomatic heart failure (HF) receiving cardiac resynchronization therapy (CRT) are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome.
  
  
  METHODS
  A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF.
  
  
  RESULTS
  During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP (> 3 mg/L) prior to CRT was associated with a significant 2.39-fold increase (P = 0.006) in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels (-0.5 ± 4.1 mg/L reduction) compared with non-responders (1.7 ± 6.1 mg/L increase, P = 0.018). Compared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations (Log-rank P < 0.001). The echocardiographic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high.
  
  
  CONCLUSIONS
  Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Chi
authors.initials: C
authors.lastname: Cai
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Li-Gang
authors.initials: LG
authors.lastname: Ding
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Ke-Ping
authors.initials: KP
authors.lastname: Chen
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Yang
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Liu
authors.affiliation: Cardiac Arrhythmia Center, Fuwai Hospital, Beilishi road No. 167, Xicheng district, Beijing 100037, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
keywords: Cardiac resynchronization therapy; Clinical outcome; Heart failure; High sensitivity C-reactive protein