The Predictive Value of Procalcitonin and High-Sensitivity C-Reactive Protein for Early Bacterial Infections in Preterm Neonates

Neonatology ◽  
2020 ◽  
Vol 118 (1) ◽  
pp. 28-36
Author(s):  
Tetsuo Naramura ◽  
Hiroko Imamura ◽  
Hidetaka Yoshimatsu ◽  
Kaname Hirashima ◽  
Shinji Irie ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Predictive Value ◽  
Early Onset ◽  
Bacterial Infections ◽  
High Sensitivity ◽  
Preterm Neonates ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Hs Crp

<b><i>Introduction:</i></b> Evidence on the reliability of using procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) as diagnostic markers for early-onset neonatal bacterial infections is still insufficient because of their physiological elevation during the early neonatal period. This study aimed to assess the respiratory influence of serum PCT and hs-CRP levels and evaluate their predictive value for bacterial infections during the first 72 h of life in preterm neonates. <b><i>Methods:</i></b> The preterm neonates enrolled in this single-center retrospective cohort study were categorized into 3 groups: reference, infection-unlikely respiratory failure, and probable bacterial infection; their serum PCT and hs-CRP levels were assessed. Subsequently, age-specific 95th percentile curves were plotted and the median and cutoff PCT and hs-CRP levels for predicting bacterial infections at birth and 7–18, 19–36, and 37–72 h after birth were determined. Moreover, the analysis of PCT and hs-CRP with a neonatal sequential organ failure assessment (nSOFA) score was performed in very low birth weight neonates. <b><i>Results:</i></b> Serum PCT levels were influenced by respiratory failure. A significant difference was found in the median PCT and hs-CRP levels among the 3 groups at each time point. PCT sensitivities for predicting bacterial infection were slightly higher than those of hs-CRP in each time frame during the first 72 h of life. In both PCT and hs-CRP, there was no significant difference between infants with nSOFA scores of &#x3e;4 and those with nSOFA scores of ≤4. <b><i>Discussion/Conclusion:</i></b> Age-specific evaluation showed that PCT has better predictive value than hs-CRP for early-onset bacterial infections in preterm neonates.

scholarly journals High Sensitivity CReactive Protein (hsCRP) Level on Premature Rupture of Membrane (PROM) at Term Pregnancy

2017 ◽  
pp. 12-15
Author(s):  
Meily Manoppo ◽  
Hermie MM Tendean ◽  
Joice MM Sondakh
Keyword(s):  
High Sensitivity ◽  
C Reactive Protein ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
Hs Crp ◽  
Cross Sectional Design ◽  
Parametric Statistical Test

Objective: To compare the level of high sensitivity C-Reactive Protein (hs-CRP) on patients with premature rupture of membranes (PROM) at term pregnancy. Methods: The study was cross-sectional design. The data collection included age, parity, gestational age, birth weight, and APGAR score on 28 pregnant women at term pregnancy consisting of 14 subjects of Premature Rupture of Membrane (PROM) less than 12 hours and the remaining one was equal or more than 12 hours. We took blood samples from the subjects for the examination of hs-CRP level. Data were analyzed using non-parametric statistical test and processed using Statistical Package for Social Sciences (SPSS) version 20. Results: The mean hs-CRP level on PROM <12-hour and 12-hour group was 12.9 and 17.8 mg/l. There was not significant difference on hs-CRP level between both of group at term pregnancy (p=0.734). Conclusion: The level of hs-CRP does not have association with the incidence of PROM. [Indones J Obstet Gynecol 2017; 5-1: 12-15] Keywords: high sensitivity C-Reactive Protein, premature ruptures of membranes, term pregnancy

Abstract 346: Platelet Reactivity to Aspirin and Clopidogrel in Patients with Acute ST Elevation Myocardial Infarction and its Correlation with High Sensitivity C- Reactive Protein

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Archana Rajdev ◽  
Oana Penciu ◽  
Jacqueline Bradley ◽  
Cristina Mihu ◽  
Alan Siqueros ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Reactivity ◽  
High Sensitivity ◽  
St Elevation Myocardial Infarction ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
St Elevation ◽  
Hs Crp

INTRODUCTION Implantation of bare metal or drug eluting stents supported by dual antiplatelet therapy (DAPT) is standard treatment for the management of patients with ST elevation myocardial infarction (STEMI). Individual response to aspirin and clopidogrel is heterogeneous, and decreased response is associated with thrombotic events following stenting. We postulated that systemic inflammation at the time of STEMI would diminish responsiveness to DAPT. The aim of this study is to evaluate the correlation between elevated high-sensitivity C-reactive protein (hs-CRP) as a marker of inflammation and decreased platelet sensitivity to DAPT in STEMI. METHODS We recruited patients with STEMI undergoing percutaneous coronary intervention (PCI) who received oral clopidogrel 600 mg loading dose followed by 75 mg daily maintenance dose and aspirin 325 mg daily. Platelet reactivity and hs-CRP were measured within 72 hours of PCI and at 6 weeks. For patients receiving eptifibatide, blood samples were taken 48 hours after discontinuation. Platelet reactivity was assessed using the VerifyNow platelet function analyzer. A cut-off value of 208 platelet reaction units (PRU) was used to define high on-clopidogrel platelet reactivity (HCPR) and a value of 454 aspirin reaction units (ARU) was used to define high on-aspirin platelet reactivity (HAPR). RESULTS In 20 patients aged 31 to 85, in hospital and 6 weeks after STEMI, hs-CRP was 6.7 (SD 4.0) and 2.6 (SD 3.2) respectively, p< 0.01. Changes in ARU from 408.3 (SD 54.3) to 425.2 (SD 68.2) and PRU from 157.8 (SD 74.7) to 164.2 (SD 75) were not statistically significant. 2 patients had HAPR in hospital; 1 became sensitive at follow up. 2 patients developed HAPR and HCPR. We saw a trend towards higher PRU in diabetic patients and those prescribed statins. CONCLUSIONS Although we found a significant difference in hs-CRP levels between the first and second time point, no significant difference was found in on-aspirin and on-clopidogrel platelet reactivity between the time points.Thus, in this small series, the acute inflammatory state associated with STEMI did not appear to influence the on-DAPT reactivity at the dosages used. Trends among those with diabetics and prescribed statins will be discussed

scholarly journals Controlled Clinical Trial Effect of Noni Fruit Extract (Morinda citrifolia) Toward Overactive Bladder Women through Observation of High-Sensitivity C-reactive Protein in Urine Levels

2020 ◽  
Vol 8 (A) ◽  
pp. 706-710
Author(s):  
Edy Ardiansyah ◽  
M. F. G. Siregar ◽  
R. A. Ganie ◽  
I. B. Utra
Keyword(s):  
Oxidative Stress ◽  
High Sensitivity ◽  
Morinda Citrifolia ◽  
C Reactive Protein ◽  
Urine Level ◽  
Fruit Extract ◽  
Reactive Protein ◽  
Significant Difference ◽  
Hs Crp ◽  
Urine Levels

BACKGROUND: The prevalence of overactive bladder (OAB) appears to increase with age (aging), and free radicals most contribute to an increase in the aging process. But now, some researchers have found the efficacy of Morinda citrifolia in inhibiting the oxidative stress process so that it is expected to be beneficial for the treatment of OAB. AIM: The aim of this study was to find out the effect of M. citrifolia extract on overactive women bladder (OAB) through observation of high-sensitivity C-reactive protein (hs-CRP) urine level. METHODS: This research is an experimental study using double-blind randomized controlled trial design conducted at General Hospital H. Adam Malik Medan, USU Pharmacy Laboratory for extraction of noni fruit (M. citrifolia) and the Integrated Laboratory of Biochemical-Biomolecular USU Faculty of Medicine for the examination of hs-CRP urine levels. A t-dependent test is performed if data distribution is normally distributed or if not normally distributed, the median values are compared with the Mann–Whitney U-test. The effect of noni in hs-CRP levels performed by wilcoxon signed-Ranks Test. The statistical significance test with CI 95% and significant difference value p<0,05. RESULTS: These results indicate that the noni fruit extract has weak antioxidant activity (IC50 >150 ppm). From the statistical analysis, a significant difference (p < 0.05) was obtained in hs-CRP urine level after compared to before treatment. These results indicate that after treatment, there was an improvement in the degree of OAB symptom scores in Group A and Group B. CONCLUSIONS: Noni fruit extract (M. citrifolia) is proven to be able to inhibit oxidative stress in urothelium through observation of hs-CRP urine levels in overactive women bladder (OAB).  

C-reactive protein as a predictor of cardiovascular risk in HIV-infected individuals

Sexual Health ◽  
2014 ◽  
Vol 11 (6) ◽  
pp. 580 ◽  
Author(s):  
Clare L. V. Westhorpe ◽  
Hans G. Schneider ◽  
Mandy Dunne ◽  
Tracey Middleton ◽  
Vijaya Sundararajan ◽  
...  
Keyword(s):  
General Population ◽  
Hiv Infection ◽  
Predictive Value ◽  
High Sensitivity ◽  
Coronary Event ◽  
C Reactive Protein ◽  
Cardiac Events ◽  
Reactive Protein ◽  
Hs Crp ◽  
Study Participants

Background In some studies HIV infection confers approximately two-fold higher risk of cardiac events compared with the general population. C-reactive protein (CRP) is a well-characterised biomarker of cardiac events in the general population and is also elevated in patients with HIV infection. The aim of this study was to determine the predictive value of CRP for cardiac events in HIV-infected individuals. Methods: We retrospectively analysed CRP levels in stored plasma samples from HIV-infected patients who did or did not experience a coronary event in a case-controlled manner. All CRP measurements were performed using a high-sensitivity assay (hs-CRP). Results: Of the study participants with samples available, we found slightly elevated hs-CRP levels in the cardiac cases (median 3.5, IQR 1.6–14.4, n=23) compared with controls (median 2.6, IQR1.2–8.3, n=49) which were shown to not be statistically significant P=0.20. Analysis of CRP as a binary variable (≥5 mg L–1) was also not statistically significant (OR: 1.32, 95% CI 0.48–3.63). Conclusions: CRP levels may indicate elevated risk of future cardiac events, however this must be interpreted with caution due to the generalised elevation of CRP during HIV infection. CRP has no predictive value for atherosclerosis, and further research is required to improve early prediction of cardiovascular disease in HIV infection.

Activity of systemic juvenile idiopathic arthritis in children immunized with pneumococcal 13-valent conjugate vaccine: prospective cohort study

2020 ◽  
Vol 15 (5) ◽  
pp. 40-50
Author(s):  
D.D. Vankova ◽  
◽  
E.I. Alekseeva ◽  
T.M. Dvoryakovskaya ◽  
R.V. Denisova ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Conjugate Vaccine ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Hs Crp ◽  
Active Disease

Evaluation of the safety profile of vaccines in patients with rheumatic diseases requires an assessment of their impact on disease activity. The effect of antipneumococcal vaccination on the activity of systemic juvenile idiopathic arthritis (sJIA) has not been studied so far. Objective. To evaluate the dynamics of sJIA activity after immunization with pneumococcal 13-valent conjugate vaccine (PCV13) of patients receiving biologicals. Patients and methods. This study included patients with sJIA in remission or active disease receiving biologicals during inpatient treatment and vaccinated with PCV13. To evaluate the effect of immunization on sJIA activity, we measured serum levels of high-sensitivity C-reactive protein (hs-CRP) and calprotectin. In addition to that, we assessed the number of new cases, when concentration of these markers was above the upper limit (UL) 4 weeks after PCV13 administration. Results. In 18 out of 53 patients in remission (34%) and 3 out of 25 patients with active sJIA (12%), hs-CRP levels were undetectable (0.1 mg/L) at both time-points (baseline and after 4 weeks). Among those with detectable hs-CRP levels in at least one time-point 4 weeks after vaccination, patients in remission (n = 35) had no significant changes in hs-CRP (median -0.17 mg/mL; 95% CI -0.84…0.41), whereas patients with active sJIA (n = 22) demonstrated a 3-fold decrease in hs-CRP level (median -0.94 mg/mL (95% CI -3.93…0.05). We observed no significant difference in calprotectin levels in the groups. Concentration of hs-CRP above the UL 4 weeks after vaccination was detected in 2 out of 53 sJIA patients in remission (4%) and none of the patients with active sJIA. Сoncentration of calprotectin above the UL 4 weeks after vaccination was detected in 8 out 53 (15%) and 5 out 25 (20%) sJIA patients in remission and with active disease, respectively. Conclusion. Vaccination against pneumococcal infection in patients with sJIA led to an increase in the level of highly sensitive laboratory markers of sJIA activity in 4–20% of patients. Key words: disease activity, safety, high-sensitivity C-reactive protein, biological drugs, calprotectin, juvenile idiopathic arthritis, pneumococcal 13-valent conjugate vaccine

scholarly journals Elevated high sensitivity C-reactive protein and uric acid levels in coronary artery ectasia.

2014 ◽  
Vol 61 (4) ◽  
Author(s):  
Şerafettin Demir ◽  
Gulhan Karakoyun ◽  
Mehmet Kanadasi
Keyword(s):  
Uric Acid ◽  
Coronary Artery ◽  
High Sensitivity ◽  
Control Group ◽  
Coronary Artery Ectasia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group I ◽  
Significant Difference ◽  
Hs Crp

The aim of this study is to examine uric asid (UA) and high sensitive C-Reactive protein (Hs-CRP) levels in patients with coronary artery ectasia (CAE). Ninety-eight patients with isolated CAE (mean age 57.5±10.3), (group-I), 110 patients with CAD but without CAE (mean age 56.3±10.7), (group-II), and 105 patients with normal coronary angiographies (mean age 58.1±10.8), (group-III) were included in the study. Blood samples of all individual were taken after coronary angiography from an antecubital vein, the patients uric acid and Hs-CRP levels were assessed. The severity of ectasia was evaluated and categorized according to Markis. A significant difference was not seen in serum uric acid and Hs-CRP levels between CAE and CAD groups. However, relative to the control group, uric acid and Hs-CRP levels in CAE and CAD groups were higher to a significant degree (p=0.001, p

scholarly journals High sensitivity C-reactive protein level in cerebrovascular accident

2020 ◽  
Vol 7 (4) ◽  
pp. 666 ◽  
Author(s):  
Sonal Rajesh Kumar ◽  
T. A. Vidya
Keyword(s):  
Case Control Study ◽  
High Sensitivity ◽  
Acute Phase Reactant ◽  
Modified Rankin Scale ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cholesterol Levels ◽  
Significant Difference ◽  
Hs Crp ◽  
Control Study

Background: Stroke is the second leading cause of death worldwide according to WHO. High sensitivity C-Reactive Protein (hs-CRP) is an acute phase reactant which is being studied extensively to delineate its role in development of stroke as well as in prognostication.  This study was done to assess correlation of hs-CRP with risk factors of stroke and its association with types of stroke and prognosis.Methods: A prospective case control study of 100 patients with acute stroke along with 100 controls was conducted with informed consent.  At baseline, hs-CRP levels were measured and Modified Rankin Scale (MRS) was assessed. On day 90 the Modified Rankin Scale was assessed again. Patients were divided into groups based on hs-CRP levels and MRS and the results were analysed.Results: Prevalence of stroke was more in men than women (p=0.0002).  Statistically significant difference was found between mean hs-CRP levels in men (4.722±0.8982 mg/L) and women (4.133±0.9446 mg/L) (p=0.005) and between cases and controls (p=0.0003). There was no significant association with type of stroke (p=0.456).  Mean total cholesterol levels between cases and controls showed statistically significant difference (p=0.0005). High MRS was significantly associated with high hs-CRP levels (p=0.003).  Higher hs-CRP on day 1 correlated with higher MRS on day 90.Conclusions: hs-CRP level is increased in stroke and shows significant association with severity of stroke and prognosis.

scholarly journals Combination of Fibrinogen and High-sensitivity C-reactive Protein Measurements is Potential in Identification of Acute Coronary Syndrome

2015 ◽  
Vol 7 (1) ◽  
pp. 31
Author(s):  
Djanggan Sargowo ◽  
Ferry Sandra
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Glucose ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Troponin I ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Hs Crp

BACKGROUND: Acute myocardial infarction (AMI) is one of cardiovascular diseases with high morbidity and mortality rates. Novel biomarkers that can detect accurately acute coronary syndrome (ACS) at early stage, are necessary to improve current strategies and/or to identify subjects who are at risk. Fibrinogen and high-sensitivity C-reactive protein (hs-CRP) roles in inflammation process could be potential for ACS early detection. This study was conducted to evaluate measurements of fibrinogen and hs-CRP on ACS.METHODS: An analytic observational study with cross sectional approach was conducted on patients with Troponin I positive. After signing informed consent, anamnesis and complete blood count were conducted. Besides that, liver function, renal function, and blood glucose tests were conducted as well. Samples of selected subjects were quantified with enzyme-linked immunosorbent assay (ELISA) for Troponin I, fibrinogen and hs-CRP. Then statistical analyses were performed.RESULTS: There were 76 subjects in each ACS and non-ACS groups. ACS group showed significant higher levels of both fibrinogen and hs-CRP compared to Non-ACS group (p=0.000). Among evaluated risk factors, diabetes mellitus (DM) (p=0.003) and hypertension (p=0.000) were significantly higher in ACS group than in non-ACS group. Among evaluated clinical factors, blood glucose (p=0.001) and age (p=0.000) were significantly higher in ACS group than in non-ACS group. Combination of fibrinogen and hs-CRP measurements showed the highest sensitivity (75.00%), specificity (80.26%), accuracy (77.63%), positive predictive value (79.19%) and negative predictive value (76.25%).CONCLUSION: Since fibrinogen and hs-CRP were increased in ACS group and combination of fibrinogen and hs-CRP measurements showed the highest sensitivity, specificity, accuracy, positive predictive value and negative predictive value, we suggest that combination of fibrinogen and hs-CRP measurements could give added value to identify ACS.KEYWORDS: fibrinogen, hs-CRP, biomarker, ACS, acute coronary syndrome, atherosclerosis, inflammation

scholarly journals High sensitivity C-reactive protein level in various manifestations of tuberculosis in children

2021 ◽  
Vol 61 (5) ◽  
pp. 253-60
Author(s):  
Radita Kusumaningrum ◽  
Moh Syarofil Anam ◽  
Dwi Wastoro Dadiyanto ◽  
Maria Mexitalia ◽  
Magdalena Sidhartani
Keyword(s):  
Community Health Center ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Reactive Protein ◽  
Significant Difference ◽  
Extra Pulmonary ◽  
Hs Crp

Background Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Of all TB patients, 40-50% are children. C-reactive protein (CRP) is produced during the inflammation process and is an indicator of active TB disease. High sensitivity CRP (hs-CRP) test has higher accuracy and sensitivity to detect CRP at lower levels. Objective To compare hs-CRP in children with TB infection, pulmonary TB, and extra-pulmonary TB. Methods This cross-sectional study of children with tuberculosis was conducted at Dr. Kariadi Hospital and the Semarang Community Health Center, Semarang, Central Java, from January 2020–February 2021. Inclusion criteria were patients aged 1–18 years with suspected TB (contact with adult TB patient or clinically suspected to have TB). Results From 95 study subjects, 19 had TB infection, 51 had pulmonary TB, and 25 had extra-pulmonary TB. There was a significant increase in hs-CRP level based on prolonged fever (P<0.001), enlarged lymph glands (P=0.004), joint swelling (P=0.006), low WHZ or BMI for age (P=0.048), positive bacteriological evidence (P<0.001), and negative/not done tuberculin skin test (P=0.001). There was a significant difference of hs-CRP level based on TB status, with the highest hs-CRP level in extra-pulmonary TB [14.3 mg/l (0.16–321.5)], followed by pulmonary TB [0.8 mg/l (0.3–129.1)], and TB infection [0.7 mg/l (0.3–20.2)]. The highest hs-CRP level for extra-pulmonary TB was found in abdominal TB [84.5 mg/l (0.6–321.5)]. Conclusion  Children with extra-pulmonary TB have significantly higher hs-CRP than children with TB infection or pulmonary TB.

scholarly journals High-sensitivity C-reactive protein and interleukin-6 as risk predictors in patients with stable angina pectoris

2020 ◽  
Vol 7 (9) ◽  
pp. 1322
Author(s):  
Shekhar Kunal ◽  
Pradeep Kumar Meena ◽  
Pooja Pathak ◽  
Himanshu Mahla ◽  
Kashish Gupta ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Stable Angina ◽  
Cardiovascular Events ◽  
High Sensitivity ◽  
Major Adverse Cardiovascular Events ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Vessel Disease ◽  
Significant Difference ◽  
Hs Crp

Background: Cardiovascular diseases are a leading cause of morbidity and mortality especially in developing countries such as India. Biomarkers such as high-sensitivity C-reactive protein (Hs-CRP) and interleukin-6 (IL-6) can help in risk stratification and better management of patients with stable angina.Methods: This was a prospective observational study wherein symptomatic patients with stable angina were enrolled. Coronary angiogram was done in those consenting to the procedure. Severity of coronary stenosis was graded as per the modified Gensini score (mGS). Hs-CRP and IL-6 levels were determined pre-procedure and 24 hours post percutaneous coronary intervention (PCI). Based on angiographic profile, patients were subdivided into four groups: group 1: normal coronaries, group 2: single vessel disease, group 3: double vessel disease and group 4: triple vessel disease. Primary outcome was occurrence of major adverse cardiovascular events over one-year period.Results: A total of 158 patients completed the study with a mean age of 62.8±9.6 years. A significant difference was observed between the four groups in terms of age, Hs-CRP and IL-6 levels. Of the 124 patients undergoing PCI, significant difference was observed in terms of pre and post procedure Hs-CRP (P<0.0001) and IL-6 levels (P<0.0001). Strong positive correlation was seen between Hs-CRP and IL-6 levels with modified Gensini scoring (mGS). Patients with MACE (15/158; 9.4%) had significantly higher levels of Hs-CRP and IL-6. Multivariate logistic regression analysis revealed that Hs-CRP, IL-6, ΔHs-CRP and ΔIL-6 were independent predictors of major adverse cardiovascular events (MACE).Conclusions: Hs-CRP and IL-6 levels were independent predictors of outcomes and can be used for risk stratification in these patients..

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