Document Detail

Independent prognostic value of elevated high-sensitivity C-reactive protein in chronic heart failure.
MedLine Citation:
PMID:  15131554     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The serum concentration of C-reactive protein (CRP) is mildly elevated in patients with chronic congestive heart failure (CHF), but this level falls well within the range found in healthy subjects. Standard clinical assays for CRP lack sensitivity within the low reference range and thus cannot be used effectively for routine clinical risk prediction. Because assays for high-sensitivity CRP (hsCRP) are now available, we can measure hsCRP to determine its predictive value for the prognosis of patients with CHF. METHODS: Serum levels of hsCRP in 108 patients with CHF and left ventricular ejection fraction (LVEF) <50% were examined. Major adverse cardiac events (death, heart transplantation, or hospitalization with worsening heart failure) during a median follow-up period of 403 days were determined. RESULTS: The concentrations of hsCRP in this study population were significantly increased with the severity of CHF. In a multivariate analysis, LVEF and serum levels of hsCRP were independent significant predictors for adverse outcomes in these patients (hazard ratio, 3.714, P =.024, and hazard ratio, 2.584, P =.047, respectively). However, hsCRP was minimally correlated with LVEF (r = -0.167, P =.084). Further analysis indicated that hsCRP might identify a different high-risk group and could improve risk stratification beyond that of LVEF. CONCLUSIONS: These findings suggest that an elevated level of hsCRP is an independent predictor of prognosis in CHF and can provide additional prognostic information for the risk stratification and treatment in patients with chronic CHF.
Wei-Hsian Yin; Jaw-Wen Chen; Hsu-Lung Jen; Meng-Cheng Chiang; Wen-Pin Huang; An-Ning Feng; Mason Shing Young; Shing-Jong Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  147     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-07     Completed Date:  2004-07-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  931-8     Citation Subset:  AIM; IM    
Division of Cardiology, Taipei, Taiwan.
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MeSH Terms
Analysis of Variance
C-Reactive Protein / analysis*
Heart Failure / blood*,  etiology,  physiopathology
Middle Aged
Multivariate Analysis
Stroke Volume*
Tumor Necrosis Factor-alpha / analysis
Reg. No./Substance:
0/Tumor Necrosis Factor-alpha; 9007-41-4/C-Reactive Protein

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