Document Detail

C-reactive protein in acute pulmonary embolism.
MedLine Citation:
PMID:  21218608     Owner:  NLM     Status:  MEDLINE    
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.
Yasin Abul; Sait Karakurt; Beste Ozben; Ahmet Toprak; Turgay Celikel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of investigative medicine : the official publication of the American Federation for Clinical Research     Volume:  59     ISSN:  1708-8267     ISO Abbreviation:  J. Investig. Med.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-07     Completed Date:  2011-08-12     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9501229     Medline TA:  J Investig Med     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  8-14     Citation Subset:  IM    
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MeSH Terms
Acute Disease
Biological Markers / blood
C-Reactive Protein / metabolism*
Middle Aged
Natriuretic Peptide, Brain / blood
Patient Admission
Peptide Fragments / blood
Predictive Value of Tests
Pulmonary Embolism / blood*,  mortality,  physiopathology,  ultrasonography
ROC Curve
Sensitivity and Specificity
Survival Analysis
Troponin T / blood
Ventricular Dysfunction, Right / blood,  complications,  physiopathology
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/Troponin T; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 9007-41-4/C-Reactive Protein

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