scholarly journals High-sensitivity C reactive protein as a predictor of inhospital mortality in patients with cardiovascular disease at an emergency department: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015112 ◽  
Author(s):  
Ryo Yoshinaga ◽  
Yasufumi Doi ◽  
Katsuhiko Ayukawa ◽  
Shizukiyo Ishikawa
Keyword(s):  
Cardiovascular Disease ◽  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
High Sensitivity ◽  
Inhospital Mortality ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

ObjectiveWe investigated whether serum high-sensitivity C reactive protein (hs-CRP) levels measured in an emergency department (ED) are associated with inhospital mortality in patients with cardiovascular disease (CVD).DesignA retrospective cohort study.SettingED of a teaching hospital in Japan.Participants12 211 patients with CVD aged ≥18 years who presented to the ED by an ambulance between 1 February 2006 and 30 September 2014 were evaluated.Main outcome measuresInhospital mortality.Results1156 patients had died. The inhospital mortality increased significantly with the hs-CRP levels (<3.0 mg/L: 7.0%, 95% CI 6.4 to 7.6; 3.1–5.4 mg/L: 9.6%, 95% CI 7.9 to 11.3: 5.5–11.5 mg/L: 11.2%, 95% CI 9.4 to 13.0; 11.6–33.2 mg/L: 12.3%, 95% CI 10.5 to 14.1 and ≥33.3 mg/L: 19.9%, 95% CI 17.6 to 22.2). The age-adjusted and sex-adjusted HR for total mortality was increased significantly in the three ≥5.5 mg/L groups compared with the <3.0 mg/L group (5.5–11.5 mg/L: HR=1.32, 95% CI 1.09 to 1.60, p=0.005; 11.6–33.2 mg/L: HR=1.38, 95% CI 1.14 to 1.65, p=0.001 and ≥33.3 mg/L: HR=2.15, 95% CI 1.84 to 2.51, p<0.001). Similar findings were observed for the CVD subtypes of acute myocardial infarction, heart failure, cerebral infarction and intracerebral haemorrhage. This association remained unchanged even after adjustment for age, sex and white cell count and withstood Bonferroni adjustment for multiple testing. When the causes of death were divided into primary CVD and non-CVD deaths, the association between initial hs-CRP levels and mortality remained significant, but the influence of hs-CRP levels was greater in non-CVD deaths than CVD deaths. The percentage of non-CVD deaths increased with hs-CRP levels; among the patients with hs-CRP levels ≥33.3 mg/L, non-CVD deaths accounted for 37.5% of total deaths.ConclusionOur findings suggest that increased hs-CRP is a significant risk factor for inhospital mortality among patients with CVD in an ED. Particular attention should be given to our finding that non-CVD death is a major cause of death among patients with CVD with higher hs-CRP levels.

scholarly journals HUBUNGAN KADAR TRIASILGLISEROL DARAH DENGAN KADAR HIGH SENSITIVITY C-REACTIVE PROTEIN PADA REMAJA OBES

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Melda Melatunan
Keyword(s):  
Cardiovascular Disease ◽  
High Sensitivity ◽  
Nonparametric Test ◽  
Inflammatory Factors ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Obese Adolescents ◽  
Reactive Protein ◽  
Triacylglycerol Level ◽  
Hs Crp

Abstract: Obesity is one of the health problem in the world, also in Indonesia. Obesity is caused by an increased amount of fat that stored in the form triacylglycerol ( TAG ) which is acquired from food. Increase of triacylglycerol level may cause higher risk of cardiovascular disease. High Sensitivity C-Reactive Protein (hs-CRP) is a marker of inflammatory factors that can be used as a marker for cardiovascular disease. This study aimed to determine the correlations between TAG levels on blood and hs-CRP levels on obese adolescents. This study performed by observational analytic study design with the cross-sectional approach. The number of sample in this study were 17 sample who was willing to join. Analysis of bivariate using Spearman nonparametric test. The results showed a significance value ( p ) 0.272 which indicates that the correlation between TAG levels and hs-CRP levels were not significant. Spearman value showed 0.282 that indicates that the direction of a positive correlation with the strength of the correlation is weak. It can be concluded that there is no correlations between TAG levels in blood with hs-CRP levels on obese adolescents. Keyword: Obesity, TAG, hs-CRP, Adolescents    Abstrak: Obesitas merupakan masalah kesehatan di seluruh dunia, termasuk di Indonesia. Obesitas disebabkan akibat peningkatan jumlah lemak yang disimpan dalam bentuk triasilgliserol (TAG) yang diperoleh dari makanan. Peningkatan triasilgliserol ini akan meningkatkan risiko penyakit kardiovaskuler. High Sensitivity C-Reactive Protein (hs-CRP) merupakan faktor penanda inflamasi yang dapat digunakan sebagai penanda risiko penyakit kardiovaskuler. Penelitian ini bertujuan untuk mengetahui hubungan kadar TAG darah dengan kadar hs-CRP pada remaja obes. Penelitian ini menggunakan desain penelitian analitik observasional dengan pendekatan cross-sectional. Sampel pada penelitian ini berjumlah 17 sampel yang diambil dari seluruh populasi yang bersedia. Analisis bivariat menggunakan uji nonparametrik Spearman. Hasil penelitian didapatkan nilai signifikansi (p) 0,272 yang menunjukkan bahwa korelasi antara kadar TAG dan kadar hs-CRP tidak signifikan. Nilai Spearman sebesar 0,282 menunjukkan bahwa arah korelasi positif dengan kekuatan korelasi yang lemah. Dapat disimpulkan bahwa tidak terdapat hubungan antara kadar TAG darah dengan kadar hs-CRP pada remaja obes. Kata Kunci : Obesitas, TAG, hs-CRP, Remaja

scholarly journals High Sensitivity C-Reactive Protein Predictive Value for Cardiovascular Disease: A Nested Case Control from Isfahan Cohort Study (ICS)

Global Heart ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 3 ◽  
Author(s):  
Pooya Koosha ◽  
Hamidreza Roohafza ◽  
Nizal Sarrafzadegan ◽  
Mehrbod Vakhshoori ◽  
Mohammad Talaei ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Predictive Value ◽  
High Sensitivity ◽  
Case Control ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Nested Case Control

scholarly journals BMI, high-sensitivity C-reactive protein and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults: a cohort study

2020 ◽  
pp. 1-8
Author(s):  
Renying Xu ◽  
Peixiao Shen ◽  
Chunhua Wu ◽  
Yanping Wan ◽  
Zhuping Fan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Serum Uric Acid Level ◽  
Fasting Blood Glucose ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Chinese Adults ◽  
Reactive Protein ◽  
Metabolically Healthy ◽  
Hs Crp

Abstract Objective: We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults. Design: Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up. Results: Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis. Conclusion: BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.

scholarly journals Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study

2020 ◽  
Author(s):  
Tao Zhou ◽  
Nan Zheng ◽  
Xiang Li ◽  
Dongmei Zhu ◽  
YI HAN
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

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