Inflammatory response in outpatients with chronic heart failure: has the C reactive protein measure any clinical usefulness?

2003 ◽  
Vol 9 (5) ◽  
pp. S75
Author(s):  
Eduardo R. Perna ◽  
Natalia Augier ◽  
Stella M. Macin ◽  
Juan P. Cimbaro Canella ◽  
Jorge Cialzeta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Inflammatory Response ◽  
Clinical Usefulness ◽  
C Reactive Protein ◽  
Reactive Protein

5947Predictive role of C-reactive protein levels in patients with ST-segment elevation acute myocardial infarction for heart failure related events

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Van Tassell ◽  
C R Trankle ◽  
D Kadariya ◽  
J M Canada ◽  
S Carbone ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Multivariate Analysis ◽  
Inflammatory Response ◽  
Composite Endpoint ◽  
The United States ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
St Segment

Abstract Background ST-segment elevation myocardial infarction (STEMI) is associated with an intense acute inflammatory response and an increased risk of death and heart failure (HF). C-reactive protein (CRP) is the inflammatory biomarker most commonly used for risk stratification in patients with cardiovascular diseases. CRP levels are known to rise and fall during STEMI in response to myocardial injury. In this study, we analyzed whether admission CRP or delayed CRP (measured at 72 hours after admission) held a greater predictive value for adverse HF events in patients with STEMI. Methods We analyzed data from the VCUART3 clinical trial enrolling 99 patients with STEMI within 12 hours of presentation at 3 sites in the United States of America treated with anakinra or placebo. CRP levels were measured with a high-sensitivity assay at time of admission and again at 72 hours later. A dedicated committee composed of individuals not involved in the conduct of the trial adjudicated HF events including a composite endpoint of death from any reason or incidence of HF defined as new-onset HF requiring hospital admission or a new prescription for a loop diuretic (D+HF) and a composite endpoint of death and HF hospitalization (D+HHF) at 1 year. We used a time-dependent Cox-regression analysis to determine the association of CRP at admission or at 72 hours with the outcomes of interest in univariate and multivariate analysis. Data are presented as median and interquartile range. (ClinicalTrials NCT01950299) Results CRP levels from admission and 72 hours were available in 90 and 87 subjects respectively and they increased from 4.6 [2.8–8.5] mg/L to 11.6 [4.6–24.5] mg/L (P<0.001). Both admission CRP (CRP0) and CRP at 72 hours (CRP72) were associated with the risk of D+HF (P=0.011 and <0.001, respectively) and of D+HHF (P=0.010 and P<0.001, respectively); however at multivariate analysis, only CRP72 remained significantly associated with the risk of D+HF (P=0.001) and D+HHF (P=0.004) while CRP0 was not. CRP72 significantly correlated with NTproBNP levels at 72 hours (NTproBNP72, Spearman rho R=+0.37, P=0.001). NTproBNP72 predicted D+HF (P=0.030) but not independently of CRP72 (P=0.096 for NTproBNP72 and P=0.007 for CRP72 at multivariate analysis including the 2 variables). NTproBNP72 did not predict D-HHF. Conclusions Among contemporary patients with STEMI, the levels of CRP at 72 hours after admission was superior to admission CRP levels for predicting the incidence of HF events, and independent of NTproBNP levels. Our results indicate the importance of the inflammatory response during STEMI, supporting the concept of inhibiting the inflammatory response as a therapeutic strategy. Acknowledgement/Funding Funded by NHLBI 1R34HL121402; Drug supply from Swedish Orphan Biovitrum

Mo-P4:250 Fluctuating high-sensitivity C reactive protein in stable chronic heart failure

2006 ◽  
Vol 7 (3) ◽  
pp. 101
Author(s):  
J.P. Araújo ◽  
A. Azevedo ◽  
F. Friões ◽  
P. Lourenço ◽  
A. Ferreira ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals C-reactive protein evaluation in communityacquired pneumonia with comorbid chronic heart failure as criterion of antibiotic prescription

Kardiologiia ◽  
2019 ◽  
Vol 59 (2S) ◽  
pp. 40-46
Author(s):  
A. A. Bobylev ◽  
S. A. Rachina ◽  
S. N. Avdeev ◽  
R. S. Kozlov ◽  
V. V. Mladov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Response ◽  
Clinical Success ◽  
C Reactive Protein ◽  
Additional Measurement ◽  
Reactive Protein ◽  
Group 2 ◽  
Serum Crp ◽  
Group 1

Aim.To prove that diagnostic algorithm based on additional measurement of serum C-reactive protein (CRP) for administration of systemic antibacterial therapy (ABT) to patients with suspected community-acquired pneumonia (CAP) and concomitant chronic heart failure (CHF) does not influence outcomes of disease.Materials and methods.This open, single-center, randomized, prospective, noninferiority study included 160 adult patients with documented functional class II–IV CHF who had been admitted with a preliminary diagnosis of non-severe CAP. Patients were randomized at 1:1 to two groups; group 1 – with additional measurement of CRP (n=80) and group 2 – with the use of routine diagnostic methods (n=80). In group 1, systemic ABT was administered only when serum CRP was >28.5 mg / l (threshold level of the biomarker calculated at the previous stage of the study); group 2 received a standard treatment. Noninferiority test result for both algorithms was evaluated by the number of patients with clinical success on days 12–14 (primary endpoint). Non-inferiority margin was δ=–13.5 %. In addition secondary endpoints (early clinical response on days 3–5; early in-hospital adverse events (development of complications; admission to intensive care unit (ICU); death), death, recurrent CAP or CHF worsening with readmission at 28 day; mortality at 90 and 180 days) were estimated. Standard statistical tools were used for all intergroup comparisons.Results:76 patients of each group reached the primary endpoint. Systemic ABT was administered to 51 (67.1 %) patients in group 1 and 76 (100 %) patients in group 2 (p<0.05). Both groups were comparable (p>0.05) regarding all endpoints: clinical success, 70 (92.1 %) vs. 69 (90.8 %), Δ=1.3 % (one-sided 97.5 % CI: – 8.25 % for non-inferiority margin δ=–13.5 %); early clinical response, 66 (86.8 %) vs. 68 (89.5 %); admission to ICU, 1 (1.3 %) vs. 1 (1.3 %); development of complications, 20 (26.3 %) vs. 22 (28.9 %); readmission, 5 (6.6 %) vs. 6 (7.9 %); in-hospital mortality, 2 (2.6 %) vs. 1 (1.3 %), mortality at 28 day, 3 (3.9 %) vs. 2 (2.6 %), at 90 day, 5 (6.6 %) vs. 4 (5.3 %), at 180 day, 8 (10.5 %) vs. 9 (11.8 %) cases, respectively.Conclusion:additional measurement of serum CRP in patients with CHF and suspected non-severe CAP was able to reduce rate of systemic ABT administration without outcomes and prognosis worsening.

scholarly journals Diagnostic, clinical and prognostic aspects determine the concentration of C-reactive protein in chronic heart failure.

2018 ◽  
Vol 96 (3) ◽  
pp. 197-207
Author(s):  
Andrey A. Bobylev ◽  
S. A. Rachina ◽  
S. N. Avdeev ◽  
A. A. Petrov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Disease Severity ◽  
Cardiac Dysfunction ◽  
Inflammatory Marker ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Incident Heart Failure

A lot of mechanisms in development and progression of cardiac dysfunction are associated with changes of multiple markers and high-sensitivity C-reactive protein is one of them. The role of this inflammatory marker in heart failure pathogenesis requires further study. However, various recent reports have suggested that C-reactive protein assessment may be used for prediction of incident heart failure, its prognosis and estimation of the disease severity.

scholarly journals Association between concentration of melatonin, and lipoproteins, LPO, hsCRP, NTproBNP in chronic heart failure patients

2014 ◽  
Vol 27 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Elzbieta Kimak ◽  
Grzegorz Dzida ◽  
Dariusz Duma ◽  
Andrzej Prystupa ◽  
Magdalena Halabis ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Nyha Class ◽  
Lipid Hydroperoxide ◽  
High Sensitivity ◽  
Class Ii ◽  
Protective Agent ◽  
Class Iii ◽  
C Reactive Protein ◽  
Reactive Protein

ABSTRACT The aim of the study was to examine concentrations and relationships between melatonin levels assessed at 0:200 hrs and 0:700 hrs, lipid hydroperoxide (LPO) assessed at 0:200 hrs and 0:700 hrs, and apolipoprotein (apo)AI, apoAII, apoB, high sensitivity C-reactive protein (hsCRP) and NT-proBNP, in 27 patients with chronic heart failure (CHF) (17 patients - with NYHA class II and 10 - with NYHA class III). In the study, Lipoproteins apoAI, apoAII, apoB, high sensitivity C-reactive protein (hsCRP) levels were determined by way of immunonephelometric methods, serum melatonin concentration was measured by using a competitive enzyme immunoassay technique, while serum LPO concentration was measured by using Cayman’s Lipid Hydroperoxide Assay Kit. In the study, CHF patients without acute inflammatory response demonstrated a decreased concentration of high density lipoprotein cholesterol (HDL-C), apoAI, apoAII levels, but an increased concentration of NT-proBNP, hsCRP and LPO at night, and LPO at daytime; however, the concentration of LPO at 0:700 was lower than at 0:200. Pearson’s correlation test and multiple ridge stepwise regression showed that melatonin administered at night exerts an effect on the composition of apoAI and apoAII of HDL particles, and induces decreased LPO at 0:700, but has no effect upon NT-proBNP levels in patients with NYHA class II. However, in patients with NYHA class III, melatonin administered at night induces an increase in the content of apoAII and apoAI, which further decreases hsCRP, and this, together with the administered melatonin, brings about daytime decreases in NT-proBNP and hsCRP levels. The results indicated that the content of apoAII and apoAI in HDL particles and melatonin demonstrate an anti-oxidative and anti-inflammatory effect, and together, have a cardio-protective effect on patients with advanced CHF. Hence, the results support melatonin being a cardio-protective agent. These relationships, however, need to be confirmed in further studies.

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