scholarly journals C-Reactive Protein and All-Cause Mortality in a Large Hospital-Based Cohort

2008 ◽  
Vol 54 (2) ◽  
pp. 343-349 ◽  
Author(s):  
Claudia Marsik ◽  
Lili Kazemi-Shirazi ◽  
Thomas Schickbauer ◽  
Stefan Winkler ◽  
Christian Joukhadar ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Acute Phase ◽  
Cox Regression ◽  
Disease Risk ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Low Sensitivity

Abstract Background: C-reactive protein (CRP), an acute-phase protein, is a sensitive systemic marker of inflammation and acute-phase reactions. Testing CRP concentrations at hospital admission may provide information about disease risk and overall survival. Methods: All first-ever transmittals to the department of medical and chemical laboratory diagnostics for determination of low-sensitivity CRP (n = 274 515, 44.5% male, median age 51 years) between January 1991 and July 2003 were included [median follow-up time: 4.4 years (interquartile range, 2.3–7.4 years)]. The primary endpoint was all-cause mortality. Multivariate Cox regression adjusted for sex and age was applied for analysis. Results: Compared to individuals within the reference category (CRP <5 mg/L), hazard ratios (HR) for all-cause mortality increased from 1.4 (5–10 mg/L category) to 3.3 in the highest category (>80 mg/L, all P <0.001). CRP was associated with various causes of death. The relation of CRP to cancer death was stronger than to vascular death. Younger patients with increased CRP had relatively far worse outcome than older patients (maximal HR: ≤30 years: 6.7 vs >60 years: 1.7–3.7). Interestingly, both short- and long-term mortality were associated with increasing CRP concentrations (>80 mg/L: HR 22.8 vs 1.4). Conclusion: Measurement of low-sensitivity CRP at hospital admission allowed for the identification of patients at increased risk of unfavorable outcome. Our findings indicate that close attention should be paid to hospitalized patients with high CRP not only because of very substantial short-term risk, but also long-term excess risk, the basis for which needs to be determined.

C-reactive protein to albumin ratio provides important long-term prognostic information in patients undergoing endovascular abdominal aortic repair

Vascular ◽  
2022 ◽  
pp. 170853812110627
Author(s):  
Gökhan Demirci ◽  
Ali Riza Demir ◽  
Begüm Uygur ◽  
Umit Bulut ◽  
Yalcin Avci ◽  
...  
Keyword(s):  
Cox Regression ◽  
Endovascular Aneurysm Repair ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Cox Regression Analysis ◽  
Reactive Protein ◽  
Abdominal Aortic ◽  
All Cause Mortality ◽  
The Impact

Background The prognostic value of C-reactive protein/albumin ratio (CAR) is of import in cardiovascular diseases. Our aim was to evaluate the impact of the CAR in patients with asymptomatic abdominal aortic aneurysm (AAA) undergoing endovascular aneurysm repair (EVAR). Material and Method We retrospectively evaluated 127 consecutive patients who underwent technically successful elective EVAR procedure between December 2014 and September 2020. The optimal CAR cut-off value was determined by using receiver operating characteristic (ROC) curve analysis. Based on the cut-off value, we investigated the association of CAR with long-term all-cause mortality. Results 32 (25.1%) of the patients experienced all-cause mortality during a mean 32.7 ± 21.7 months’ follow-up. In the group with mortality, CAR was significantly higher than in the survivor group (4.63 (2.60–11.88) versus 1.63 (0.72–3.24), p < 0.001). Kaplan–Meier curves showed a higher incidence of all-cause mortality in patients with high CAR compared to patients with low CAR (log-rank test, p < 0.001). Multivariable Cox regression analysis revealed that glucose ≥ 110 mg/dL (HR: 2.740; 95% CI: 1.354–5.542; p = 0.005), creatinine ≥ 0.99 mg/dL (HR: 2.957, 95% CI: 1.282–6.819, p = 0.011) and CAR > 2.05 (HR: 8.190, 95% CI: 1.899–35.320, p = 0.005) were the independent predictors of mortality. Conclusion CAR was associated with a significant increase in postoperative long-term mortality in patients who underwent EVAR. Preoperatively calculated CAR can be used as an important prognostic factor.

Acute-Phase Plasma PCSK9 Levels and Recurrent Cardiovascular Events in a Chinese Acute Myocardial Infarction Cohort

Cardiology ◽  
2018 ◽  
Vol 141 (2) ◽  
pp. 88-97 ◽  
Author(s):  
Yan Gao ◽  
Yan Qiu ◽  
Jihua Wu ◽  
Wei Diao ◽  
Haibo Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Phase ◽  
Recurrent Events ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Female Gender ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular (CV) disease. Whether plasma PCSK9 measured during the acute phase predicts recurrent CV events in patients with acute myocardial infarction (AMI) remains unresolved. Methods and Results: Plasma PCSK9 levels were measured in 1,646 patients with AMI from the China PEACE-Prospective AMI Study at the acute phase. Additionally, 248 patients were resampled and measured at 1 month post-AMI. Associations of acute-phase PCSK9 tertiles with clinical characteristics and recurrent CV events within 1 year were assessed. Female gender (OR 1.94, 95% CI 1.24–3.03), premature coronary heart disease (CHD; OR 2.12, 95% CI 1.37–3.26), higher high-sensitivity C-reactive protein (OR 1.67, 95% CI 1.44–1.95), and higher triglycerides (OR 1.46, 95% CI 1.03–2.09) were associated with higher baseline PCSK9. Plasma PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events in the AMI cohort (HR 0.78, 95% CI 0.52–1.16) or any subgroup. There was also no association between percentage changes in PCSK9 over the first month and 1-year recurrent events, although there was a trend of differences between patients in the upper versus lower tertiles. Conclusion: Plasma PCSK9 levels measured during the acute phase were associated with high-sensitivity C-reactive protein, triglycerides, premature CHD, and gender in patients with AMI but did not predict recurrent CV events within 1 year. Dynamic changes in PCSK9 suggested a trend yet no significance value in predicting recurrent CV events.

scholarly journals Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes

2020 ◽  
Vol 9 (3) ◽  
pp. 753
Author(s):  
Shailesh Kumar Samal ◽  
Abdul Rashid Qureshi ◽  
Mizanur Rahman ◽  
Peter Stenvinkel ◽  
Johan Frostegård
Keyword(s):  
Significant Risk ◽  
Premature Death ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Multivariate Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Low Levels ◽  
Antibody Levels

Patients on haemodialysis (HD-patients) have an increased risk of premature death. Low levels of IgM antibodies against malondialdehyde (anti-MDA) are associated with increased risk of cardiovascular disease (CVD) with underlying potential mechanisms described. Here, we studied subclasses and isotypes of anti-MDA in 210 HD-patients with mortality as outcome (56% men, median age 66, Interquartile range (IQR) 51–74 years, vintage time 29 (15–58) months, mean follow up period of 41 (20–60)months). Patients were also divided into inflamed c-reactive protein (CRP >5.6 mg/mL) and non-inflamed. Antibody levels were measured by ELISA. In multivariate risk analysis, patients in low tertile of IgM anti-MDA sub-distribution hazard ratio (sHR 0.54); 95% confidence interval (CI: 0.34–0.89) inversely and significantly associated with all-cause mortality after five years, after adjusting for confounders. Low tertile of IgG (sHR 0.48, 95%CI: 0.25–0.90, p = 0.02) and IgG1 (sHR 0.50, CI: 0.24–1.04, p = 0.06) was associated low mortality among non-inflamed patients. In contrast, anti-MDA IgG2 among inflamed patients was significantly associated with increased mortality, IgG2(sHR 2.33, CI: 1.16–4.68, p = 0.01). IgM anti-MDA was a novel biomarker among HD-patients with low levels being associated with mortality, while low levels of IgG and IgG1 but not IgA anti-MDA were associated with mortality only among non-inflamed patients. IgG2 anti-MDA was a significant risk marker among inflamed patients, which could be related to infection.

scholarly journals C-reactive protein for predicting all-cause mortality in patients with acute ischemic stroke: a meta-analysis

2019 ◽  
Vol 39 (2) ◽  
Author(s):  
Bo Yu ◽  
Ping Yang ◽  
Xuebi Xu ◽  
Lufei Shao
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Observational Studies ◽  
Meta Analysis ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Reactive Protein ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Unit Increase

Abstract Studies on the association of C-reactive protein (CRP) with all-cause mortality in acute ischemic stroke patients have yielded conflicting results. The objective of this meta-analysis was to evaluate the prognostic value of CRP elevation in predicting all-cause mortality amongst patients with acute ischemic stroke. We searched the original observational studies that evaluated the association of CRP elevation with all-cause mortality in patients with acute ischemic stroke using PubMed and Embase databases until 20 January 2018. Pooled multivariate-adjusted hazard ratio (HR) with 95% confidence intervals (CI) of all-cause mortality was obtained for the highest compared with the lowest CRP level or per unit increment CRP level. A total of 3604 patients with acute ischemic stroke from eight studies were identified. Acute ischemic stroke patients with the highest CRP level were independently associated with an increased risk of all-cause mortality (HR: 2.07; 95% CI: 1.60–2.68) compared with the lowest CRP category. The pooled HR of all-cause mortality was 2.40 (95% CI: 1.10–5.21) for per unit increase in log-transformed CRP. Elevated circulating CRP level is associated with the increased risk of all-cause mortality in acute ischemic stroke patients. This meta-analysis supports the routine use of CRP for the death risk stratification in such patients.

scholarly journals Circulating Fetuin-A and Risk of Ischemic Stroke in Women

2014 ◽  
Vol 60 (1) ◽  
pp. 165-173 ◽  
Author(s):  
Monik C Jiménez ◽  
Qi Sun ◽  
Markus Schürks ◽  
Frank B Hu ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Disease Risk ◽  
Conditional Logistic Regression ◽  
Menopausal Status ◽  
C Reactive Protein ◽  
Fetuin A ◽  
Reactive Protein ◽  
Increased Risk ◽  
Hormone Use ◽  
Incident Cases

Abstract BACKGROUND Fetuin-A, a protein secreted primarily by the liver, has been associated with nonalcoholic fatty liver disease and insulin resistance. In a recent study, higher circulating fetuin-A was associated with cardiovascular events, particularly ischemic stroke. However, these data have not been replicated. METHODS A nested case control design was used to examine the relationship between fetuin-A and ischemic stroke among female participants of the Nurses' Health Study. Fetuin-A was measured in blood samples collected and stored between 1989 and 1990. A total of 459 incident cases of ischemic stroke were identified and confirmed by medical records according to the National Survey of Stroke criteria between 1990 and 2006 and matched to 459 controls by age, race/ethnicity, date of sample collection, menopausal status, postmenopausal hormone use, and smoking status. The association between fetuin-A and ischemic stroke was modeled using conditional logistic regression. RESULTS Circulating fetuin-A was higher in women (P &lt; 0.01) who reported increased body mass index (BMI) of ≥25 kg/m2, total cholesterol ≥200 mg/dL, high-sensitivity C-reactive protein ≥3 mg/L, and current hormone use at baseline. Significant partial Spearman correlations (P &lt; 0.001), adjusted for matching factors, were found between measured concentrations of fetuin-A and triglycerides (r = 0.20), C-reactive protein (r = 0.14), and BMI (r = 0.15). Fetuin-A quartiles were not significantly associated with increased risk of incident ischemic stroke when adjusted for matching factors (relative risk, 1.03; 95% CI, 0.69–1.54, extreme quartiles); additional adjustment for lifestyle factors or cardiovascular disease risk factors and biomarkers did not alter results. CONCLUSIONS In this sample of women, fetuin-A was not significantly associated with risk of ischemic stroke. Further research is needed to explore this association.

scholarly journals High-risk lifestyle and all-cause mortality in older Australians with stroke: A data linkage study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W Peng ◽  
Andrew Hayen ◽  
J a n e Maguire ◽  
J o n Adams ◽  
David Sibbritt
Keyword(s):  
Public Health ◽  
High Risk ◽  
Cox Regression ◽  
Healthy Lifestyle ◽  
Lifestyle Factors ◽  
Stroke Survivors ◽  
Vigorous Exercise ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Stroke prevention via lifestyle modification is a public health priority in developed countries. Few studies have examined the association of high-risk lifestyle factors with long-term mortality of stroke survivors. Therefore, this study aims to explore the effect of key lifestyle factors on all-cause mortality after stroke. Methods Sample is derived from the 45 and Up Study, the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. The lifestyle data in the 45 and Up Study between 2006 to 2015 were linked with data from the NSW Registry of Births, Deaths and Marriages, NSW Cause of Death Unit Record File, and NSW Admitted Patient Data Collection by the Centre for Health Record Linkage. We defined a high-risk lifestyle as no vigorous exercise, smokers, or &gt; 10 alcoholic drinks/week. Multivariate Cox regression model is used to examine the effect of high-risk lifestyle on survival using 10-year all-cause mortality as the main outcome, adjusted for key confounders. Results We analysed information on 8410 adults with a stroke event occurring prior to the baseline 45 and Up Study, and 31% of them died in 10 years. 6219 participants were identified as having a high-risk lifestyle at baseline. Being a current smoker and without vigorous exercise were associated with 41% (95% CI: 16%, 73%) and 52% (95% CI: 30%, 78%) increase in the likelihood of death in 10 years, respectively. However, high-risk alcohol drinking was not significantly associated with survival. Of note, having cardiovascular-related comorbidities showed greater risks of mortality (HR range, 3.6-7.2). Conclusions High-risk lifestyle factors were associated with an increased risk of long-term all-cause mortality, suggesting that enhancing public health initiatives to promote 'healthy' lifestyle behaviours can be of great benefit to stroke survivors. Key messages It is essential for stroke survivors to maintain a healthy lifestyle to delay all-cause mortality. Stroke survivors with high-risk lifestyle may be associated with increased likelihood of death if they have comorbidities such as diabetes and hypertension.

scholarly journals Long-Term All-Cause Mortality and Its Association with Cardiovascular Risk Factors in Thyroid Cancer Survivors: An Israeli Population-Based Study

2020 ◽  
Author(s):  
Elena Izkhakov ◽  
Lital Keinan-Boker ◽  
Micha Barchana ◽  
Yacov Shacham ◽  
Iris Yaish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Thyroid Cancer ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cox Regression ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background: The global incidence of thyroid cancer (TC) has risen considerably during the last three decades, while prognosis is generally favorable. We assessed the long-term all-cause mortality in TC survivors compared to the general population, and its association with cardiovascular risk factors. Methods: Individuals diagnosed with TC during 2001-2014 (TC group) and age- and sex-matched individuals from the same Israeli healthcare system without thyroid disease or a cancer history (non-TC group) were compared. Cox regression hazard ratios (HRs) and 95% confidence intervals (95%CIs) for all-cause mortality were calculated by exposure status. Results: During a 15-year follow-up (median 8 years), 577 TC survivors out of 5,677 (10.2%) TC patients and 1,235 individuals out of 23,962 (5.2%) non-TC patients died. The TC survivors had an increased risk of all-cause mortality (HR=1.89, 95%CI 1.71-2.10), after adjusting for cardiovascular risk factors already present at follow-up initiation. This increased risk was most pronounced in the 55- to 64-year-old age group (HR=1.49, 95%CI 1.33-1.67). The TC survivors who died by study closure had more hypertension (14.6% vs. 10.3%, P = 0.002), more dyslipidemia (11.4% vs. 7.2%, P < 0.001), and more cardiovascular disease (33.6% vs. 22.3%, P = 0.05) compared to those who died in the non-TC group. Conclusions: This large cohort study showed higher all-cause mortality with a higher prevalence of hypertension, dyslipidemia, and cardiovascular disease among TC survivors compared to matched non-TC individuals. Primary and secondary prevention of cardiovascular risk factors in TC survivors is mandatory.

scholarly journals Association between Cardiovascular Risk Factors and Long-Term All-Cause Mortality in Thyroid Cancer Survivors: An Israeli Population-Based Study

2020 ◽  
Author(s):  
Elena Izkhakov ◽  
Lital Keinan-Boker ◽  
Micha Barchana ◽  
Yacov Shacham ◽  
Iris Yaish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Thyroid Cancer ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cox Regression ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background: The global incidence of thyroid cancer (TC) has risen considerably during the last three decades, while prognosis is generally favorable. We assessed the association between long-term all-cause mortality and cardiovascular risk factors in TC survivors compared to the general population. Methods: Individuals diagnosed with TC during 2001-2014 (TC group) and age- and sex-matched individuals from the same Israeli healthcare system without thyroid disease or a cancer history (non-TC group) were compared. Cox regression hazard ratios (HRs) and 95% confidence intervals (95%CIs) for all-cause mortality were calculated by exposure status. Results: During a 15-year follow-up (median 8 years), 577 TC survivors out of 5,677 (10.2%) TC patients and 1,235 individuals out of 23,962 (5.2%) non-TC patients died. The TC survivors had an increased risk of all-cause mortality (HR=1.89, 95%CI 1.71-2.10), after adjusting for cardiovascular risk factors already present at follow-up initiation. This increased risk was most pronounced in the 55- to 64-year-old age group (HR=1.49, 95%CI 1.33-1.67). The TC survivors who died by study closure had more hypertension (14.6% vs. 10.3%, P = 0.002), more dyslipidemia (11.4% vs. 7.2%, P < 0.001), and more cardiovascular disease (33.6% vs. 22.3%, P = 0.05) compared to those who died in the non-TC group. Conclusions: This large cohort study showed higher all-cause mortality with a higher prevalence of hypertension, dyslipidemia, and cardiovascular disease among TC survivors compared to matched non-TC individuals. Primary and secondary prevention of cardiovascular risk factors in TC survivors is mandatory.

scholarly journals Clinical outcome of out-of-hospital vs. in-hospital cardiac arrest survivors presenting with ventricular tachyarrhythmias

2021 ◽  
Author(s):  
Julian Müller ◽  
Michael Behnes ◽  
Tobias Schupp ◽  
Linda Reiser ◽  
Gabriel Taton ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
Prognostic Impact ◽  
Ventricular Tachyarrhythmias ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Hospital Cardiac Arrest

AbstractLimited data regarding the prognostic impact of ventricular tachyarrhythmias related to out-of-hospital (OHCA) compared to in-hospital cardiac arrest (IHCA) is available. A large retrospective single-center observational registry with all patients admitted due to ventricular tachyarrhythmias was used including all consecutive patients with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Survivors discharged after OHCA were compared to those after IHCA using multivariable Cox regression models and propensity-score matching for evaluation of the primary endpoint of long-term all-cause mortality at 2.5 years. Secondary endpoints were all-cause mortality at 6 months and cardiac rehospitalization at 2.5 years. From 2.422 consecutive patients with ventricular tachyarrhythmias, a total of 524 patients survived cardiac arrest and were discharged from hospital (OHCA 62%; IHCA 38%). In about 50% of all cases, acute myocardial infarction was the underlying disease leading to ventricular tachyarrhythmias with consecutive aborted cardiac arrest. Survivors of IHCA were associated with increased long-term all-cause mortality compared to OHCA even after multivariable adjustment (28% vs. 16%; log rank p = 0.001; HR 1.623; 95% CI 1.002–2.629; p = 0.049) and after propensity-score matching (28% vs. 19%; log rank p = 0.045). Rates of cardiac rehospitalization rates at 2.5 years were equally distributed between OHCA and IHCA survivors. In patients presenting with ventricular tachyarrhythmias, survivors of IHCA were associated with increased risk for all-cause mortality at 2.5 years compared to OHCA survivors.

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