Predictive value of high sensitivity C-reactive protein in the diagnosis and outcomes of acute aortic syndromes.
OBJECTIVE
The purpose of this study was to determine whether high-sensitivity C-reactive protein (hsCRP) levels differ among patients with acute aortic syndromes (AAS) and if hsCRP could predict their long-term outcomes.


METHODS
Retrospective observational study.


METHODS
Cleveland Clinic Hospital, Cleveland, Ohio.


METHODS
115 consecutive patients with AAS admitted to the cardiac intensive care unit.


METHODS
HsCRP and other laboratory data were measured within 24 h of admission. Demographic, imaging and laboratory data were obtained at the time of presentation. For the long-term survival analysis, the social security death index was used to determine all-cause mortality.


METHODS
HsCRP levels among AAS patients.


RESULTS
Hospital mortality was 4.3% for AAS patients. HsCRP levels differed significantly among AAS; the median hsCRP was higher in the aortic dissection group (49 mg/l) than in those with penetrating aortic ulcer (28 mg/l), symptomatic aortic aneurysm (14 mg/l), and intramural haematoma (10 mg/l); (p=0.02). In multivariable analysis, aortic dissection patients had higher hsCRP levels than intramural haematoma (p=0.03) and symptomatic aortic aneurysm (p=0.04) patients, after adjusting for age and gender. Multivariable Cox regression analyses showed that elevated hsCRP levels at presentation were associated with a higher long-term mortality (p=0.007).


CONCLUSIONS
Among patients with AAS, those with aortic dissection have the highest hsCRP levels at presentation. Elevated hsCRP independently predicted a higher long-term mortality in AAS patients.
Carilion Clinic and Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, Virginia, USA.
Soufian T
ST
AlMahameed
Department of Cardiology, Cleveland Clinic Florida, Weston, Florida, USA.
Gian M
GM
Novaro
Department of Cardiology, Cleveland Clinic Florida, Weston, Florida, USA.
Craig R
CR
Asher
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
Penny L
PL
Hougthaling
Department of Cardiology, Cleveland Clinic Florida, Weston, Florida, USA.
Rodrigo M
RM
Lago
VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.
Deepak L
DL
Bhatt
Interventional Cardiology and Vascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Amjad T
AT
AlMahameed
The Scripps Research Institute and Scripps Clinic, La Jolla, California, USA.
Eric J
EJ
Topol
C Reactive protein; aneurysm; aortic diseases; aortic root disease; biochemical markers; cytokines; dissecting; inflammation; outcomes; vascular heart disease