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- Title
Prognostic Value of Plasma Levels of High Sensitivity C-Reactive Protein in Chronic Systolic Heart Failure of Ischemic Origin.
- Authors
Galal, Haitham; Awad, Omar; Ghareeb, Magdi; Samir, Ayman; Selim, Remoun
- Abstract
Background Hs C-reactive protein levels have been shown in multiple prospective epidemiological studies to predict vascular risk (myocardial infarction, stroke,.. etc) and some data are available regarding the prognostic impact of hs C-reactive protein levels in patients with CHF. Objective To investigate the relationship between hs-CRP and prognosis in patients with CHF and LV systolic dysfunction of ischemic originn. Methods The study included 50 patients who were admitted to Ain Shams University Hospital and Coptic Hospital presenting and suffering from decompensated heart failure with EF <40% by echocardiography and a diagnosis of ischemic cardiomyopathy. All patients were subjected to history taking, complete physical examination, chest x-ray, 12 leads surface ECG, transthoracic echocardiography, chemistry profile, and hs-CRP samples. All patients received standard treatment for ischemic cardiomyopathy and clinical follow up was done for 3 months to determine cardiovascular morbidity (Clinical worsening of heart failure with hospital readmission, intensification of treatment and complications), and cardiovascular mortality including pump failure or vascular death. Results The results showed that 27 of patients (54%) presented with NYHA III, 21% (42%) with NYHA II and 2% (4%) with NYHA IV. About 27(54%) cases had worsening heart failure on follow up, 21 cases of them (77.8%) was having NYHA class III/IV on presentation with significant correlation. The LVEF was significantly lower (mean EF= 33%) in patients with worsening heart failure than those without worsening of their heart failure (mean EF= 37%). Regarding hs-CRP, it was significantly higher in cases with worsening heart failure than those without worsening heart failure (3.8mg% vs 1.8mg%, P <0.001) with a significant negative correlation with LVEF% (p <0.009), a significant positive correlation with NYHA (p <0.007), and a borderline positive significant correlation with SBP and DBP. Using a stepwise linear regression model, HTN was found to be a risk factor increasing HS CRP, and ACEI drug was found to be a protective factor decreasing HS CRP. hS-CRP ≥3.0 was a highly sensitive (81.5%) and a highly specific (87%) prognostic test of heart failure. Conclusions Hs-CRP levels measured once during hospitalization in patients with heart failure may predict, in an independent way, a higher hospitalization rate and readmission within a shorter period in cases of deteriorating heart failure. However, these preliminary data about the value of CRP in heart failure need to be confirmed with larger studies.
- Subjects
HEART failure; C-reactive protein; HEART disease prognosis; ECHOCARDIOGRAPH research; CARDIOMYOPATHIES; HOSPITAL care
- Publication
Heart Mirror Journal, 2013, Vol 7, Issue 2, p123
- ISSN
1687-6652
- Publication type
Article