title: C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis.
abstract: The prognostic role of baseline C-reactive protein (CRP) in chronic obstructive pulmonary disease (COPD) is controversial. In order to clarify this issue, we performed a systematic review and meta-analysis to assess the predictive effect of baseline CRP level in COPD patients. 15 eligible articles focusing on late mortality in COPD were included in our study. We performed a random-effects meta-analysis, and assessed heterogeneity and publication bias. We pooled hazard ratio (HR) estimates and their 95% confidence intervals on mortality for the comparison between the study-specific highest category of CRP level versus the lowest category. In overall analysis, elevated baseline CRP levels were significantly associated with higher mortality (HR 1.53, 95% CI 1.32-1.77, I2=68.7%, p<0.001). Similar results were observed across subgroups. However, higher mortality risk was reported in studies using a cut-off value of 3 mg·L-1(HR 1.61, 95% CI 1.12-2.30) and in those enrolling an Asiatic population (HR 3.51, 95% CI 1.69-7.31). Our analysis indicates that baseline high CRP level is significantly associated with higher late mortality in patients with COPD. Further prospective controlled studies are needed to confirm these data.
authors.affiliation: Thoracic Surgery Unit, IRCCS Istituto Nazionale dei Tumori Foundation, Milan, Italy giovanni.leuzzi@istitutotumori.mi.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Leuzzi
authors.affiliation: Dept of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Galeone
authors.affiliation: Immunohematology and Transfusion Medicine Service, IRCCS Istituto Nazionale dei Tumori Foundation, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Taverna
authors.affiliation: Thoracic Surgery Unit, IRCCS Istituto Nazionale dei Tumori Foundation, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Suatoni
authors.affiliation: Dept of Pathology and Laboratory Medicine, IRCCS Istituto Nazionale dei Tumori Foundation, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Morelli
authors.affiliation: Thoracic Surgery Unit, IRCCS Istituto Nazionale dei Tumori Foundation, Milan, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Pastorino
mesh_terms: D044466:Asian People; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000208:ethnology / Q000378:metabolism* / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein