scholarly journals Utility of the combination of serum highly-sensitive C-reactive protein level at discharge and a risk index in predicting readmission for acute exacerbation of COPD,

2014 ◽  
Vol 40 (5) ◽  
pp. 495-503 ◽  
Author(s):  
Chun Chang ◽  
Hong Zhu ◽  
Ning Shen ◽  
Xiang Han ◽  
Yahong Chen ◽  
...  
Keyword(s):  
Smoking Status ◽  
Risk Index ◽  
Chronic Obstructive Lung Disease ◽  
High Sensitivity ◽  
Hazard Ratio ◽  
Chronic Obstructive ◽  
Risk Category ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Exacerbation Of Copd

OBJECTIVE: Frequent readmissions for acute exacerbations of COPD (AECOPD) are an independent risk factor for increased mortality and use of health-care resources. Disease severity and C-reactive protein (CRP) level are validated predictors of long-term prognosis in such patients. This study investigated the utility of combining serum CRP level with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) exacerbation risk classification for predicting readmission for AECOPD. METHODS: This was a prospective observational study of consecutive patients hospitalized for AECOPD at Peking University Third Hospital, in Beijing, China. We assessed patient age; gender; smoking status and history (pack-years); lung function; AECOPD frequency during the last year; quality of life; GOLD risk category (A-D; D indicating the greatest risk); and serum level of high-sensitivity CRP at discharge (hsCRP-D). RESULTS: The final sample comprised 135 patients. Of those, 71 (52.6%) were readmitted at least once during the 12-month follow-up period. The median (interquartile) time to readmission was 78 days (42-178 days). Multivariate analysis revealed that serum hsCRP-D ≥ 3 mg/L and GOLD category D were independent predictors of readmission (hazard ratio = 3.486; 95% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 1.342-3.610; p = 0.002, respectively). The ordering of the factor combinations by cumulative readmission risk, from highest to lowest, was as follows: hsCRP-D ≥ 3 mg/L and GOLD category D; hsCRP-D ≥ 3 mg/L and GOLD categories A-C; hsCRP-D < 3 mg/L and GOLD category D; hsCRP-D < 3 mg/L and GOLD categories A-C. CONCLUSIONS: Serum hsCRP-D and GOLD classification are independent predictors of readmission for AECOPD, and their predictive value increases when they are used in combination.

scholarly journals Seasonal and Sex Variation of High-Sensitivity C-Reactive Protein in Healthy Adults: A Longitudinal Study

2009 ◽  
Vol 55 (2) ◽  
pp. 313-321 ◽  
Author(s):  
David E Chiriboga ◽  
Yunsheng Ma ◽  
Wenjun Li ◽  
Edward J Stanek ◽  
James R Hébert ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
High Sensitivity ◽  
Early Summer ◽  
Healthy Adults ◽  
Risk Category ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Future Clinical Practice ◽  
Major Factors

Abstract Background: Cross-sectional studies have reported seasonal variation in high-sensitivity C-reactive protein (hsCRP). However, longitudinal data are lacking. Methods: We collected data on diet, physical activity, psychosocial factors, physiology, and anthropometric measurements from 534 healthy adults (mean age 48 years, 48.5% women, 87% white) at quarterly intervals over a 1-year period between 1994 and 1998. Using sinusoidal regression models, we estimated peak-to-trough amplitude and phase of the peaks. Results: At baseline, average hsCRP was 1.72 mg/L (men, 1.75 mg/L; women, 1.68 mg/L). Overall seasonal variation amplitude was 0.16 mg/L (95% CI 0.02 to 0.30) and was lower in men (0.10 mg/L, 95% CI −0.11 to 0.31) than in women (0.23 mg/L, 95% CI 0.04 to 0.42). In both sexes, hsCRP peaked in November, with a corresponding trough in May. Relative plasma volume, waist and hip circumference, diastolic blood pressure, and depression scores were major factors associated with changes in amplitude of seasonal variation of hsCRP, and taken together explain most of the observed seasonal change. There was a 20% increase in the percentage of participants classified in the high-risk category for hsCRP (≥3 mg/L) during late fall and early winter compared with late spring and early summer. Conclusions: Concentrations of hsCRP were modestly increased in fall and winter compared to summer, with greater seasonal amplitude of variation observed in women. Conventional classification methods fail to consider seasonality in hsCRP and may result in substantial misclassifications in the spring and fall. Future clinical practice and research should take these variations into account.

Changes in High-sensitivity C-reactive Protein Levels after Laparoscopic Gastric Stapling Procedures versus Laparoscopic Gastric Banding

2014 ◽  
Vol 80 (10) ◽  
pp. 1044-1048
Author(s):  
Alana Gebhart ◽  
Monica Young ◽  
James Villamere ◽  
Anderson Shih ◽  
Ninh T. Nguyen
Keyword(s):  
Cardiovascular Risk ◽  
Gastric Banding ◽  
Laparoscopic Gastric Banding ◽  
High Sensitivity ◽  
Risk Category ◽  
Morbidly Obese ◽  
C Reactive Protein ◽  
Preoperative Body Mass Index ◽  
Reactive Protein ◽  
Hs Crp

Obesity, hypertension, diabetes, and hyperlipidemia are risk factors for the development of coronary artery disease. High-sensitivity C-reactive protein (hs-CRP) is an inflammatory biomarker that has been shown to be an independent predictor for cardiovascular risk. The aim of the current study was to examine the changes in cardiovascular risk profile in morbidly obese patients who underwent laparoscopic gastric stapling procedures (bypass and sleeve) compared with laparoscopic gastric banding. Levels of hs-CRP were measured preoperatively and at 12 to 24 months post-operatively. Based on hs-CRP levels, cardiovascular risk was categorized as low (less than 1 mg/L), moderate (1 to 3 mg/L), or high (greater than 3 mg/L). A total of 52 patients underwent gastric stapling procedures and 49 underwent gastric banding and both had preoperative and postoperative hs-CRP levels measured. There were no significant differences in age, gender, or preoperative body mass index (BMI) between groups. At baseline, 48.0 per cent of patients undergoing gastric stapling and 38.8 per cent of patients undergoing gastric banding had moderate or high cardiovascular risk. BMI at 24 months was significantly lower in the gastric stapling compared with the gastric banding group (30.4 ± 5.4 vs 36.1 ± 5.5 kg/m2, respectively, P < 0.01). Of the patients with elevated cardiovascular risk, 64.0 per cent of gastric stapling versus 57.8 per cent of gastric banding patients had a reduction in risk category at 12 to 24 months follow-up, whereas 1.9 per cent of patients undergoing gastric stapling versus 4.1 per cent of patients undergoing gastric banding had an increase in risk category. The mean reduction in hs-CRP level for patients with elevated cardiovascular risk was greater for gastric stapling compared with gastric banding procedures (-1.10 ± 0.94 mg/L vs -0.67 ± 0.82 mg/L, respectively, P < 0.05). Cardiovascular risk improved in the majority of patients after bariatric surgery, but a more pronounced improvement occurred in patients who underwent gastric stapling procedures.

scholarly journals C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD

2014 ◽  
Vol 45 (1) ◽  
pp. 76-86 ◽  
Author(s):  
Tristan W. Clark ◽  
Marie-Jo Medina ◽  
Sally Batham ◽  
Martin D. Curran ◽  
Surendra Parmar ◽  
...  
Keyword(s):  
Detection Rate ◽  
Multiple Logistic Regression Analysis ◽  
Respiratory Viruses ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Bacterial Detection ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Exacerbation Of Copd ◽  
The Relationship

Both viruses and bacteria are thought to cause exacerbations of chronic obstructive pulmonary disease (COPD); however, the relative importance of each remains uncertain. C-reactive protein (CRP) levels increase during exacerbations but the relationship with aetiology is not established. We aimed to explore the relationship between serum CRP and the rate of detection of viruses and bacteria.This was a prospectively recruited, observational study of patients hospitalised with exacerbations of COPD. Nasopharyngeal swabs were tested for respiratory viruses by reverse transcriptase-PCR. Sputum and blood were collected for bacterial culture and urine tested for pneumococcal antigen. CRP levels were measured on sera. CRP and other factors associated with viral, bacterial or mixed detection were assessed using multiple logistic regression analysis.264 patients with exacerbations of COPD were studied: 26% tested positive for respiratory viruses only, 13% had bacteria only, 12% had mixed viral/bacterial detection, and 49% had no pathogens detected. CRP level and temperature were strongly associated with viral detection rate (p<0.001 and p=0.004, respectively) and mixed viral/bacterial detection rate (p=0.02 and p=0.03, respectively) on multivariate analysis. Bacterial detection rate was not associated with CRP level or body temperature.This study supports the role of viruses as important aetiological agents causing exacerbations of COPD.

scholarly journals Association of high-sensitivity C-reactive protein and long-term mortality may differ from lipoprotein(a) levels among patients undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Guo ◽  
L Lei ◽  
M Ying ◽  
B Wang ◽  
J Liu ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
High Sensitivity ◽  
Hazard Ratio ◽  
Cholesterol Concentration ◽  
C Reactive Protein ◽  
Lipoprotein A ◽  
Reactive Protein ◽  
Hs Crp ◽  
Long Term Mortality

Abstract Background The use of high-sensitivity C-reactive protein (hs-CRP) as an inflammation biomarker in predicting long-term mortality remains controversial. We aimed to investigate whether the association of hs-CRP with long-term mortality differs from another inflammation biomarker, lipoprotein(a), in patients undergoing coronary angiography (CAG). Methods A total of 2422 patients undergoing CAG were included in the final analysis from a prospective, observational study. We divided them into 4 groups according to hs-CRP level (high ≥4.8 mg/l, low &lt;4.8 mg/l) and lipoprotein(a) level (high ≥17 mg/dl, low &lt;17 mg/dl). Results The overall incidence of all-cause long-term mortality was 133/2422 (5.5%). In the high lipoprotein(a) group, after adjusting for LDL-cholesterol concentration (LDL-C), age, sex, smoking status, diabetes mellitus and estimated glomerular filtration rate (eGFR), a high hs-CRP level was an independent predictor of all-cause long-term mortality (hazard ratio: 2.01; 95% CI: 1.13–3.54; p=0.02). In the low lipoprotein(a) group, a similar result was not found (hazard ratio: 1.42; 95% CI: 0.92–2.01; p=0.24). Conclusions Our data suggested that the association of hs-CRP with all-cause long-term mortality may differ from lipoprotein(a) levels among patients undergoing CAG. In addition to hs-CRP, a high lipoprotein(a) level might be a simultaneous intervention target for improving long-term prognosis in the future. Funding Acknowledgement Type of funding source: None

Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters

2017 ◽  
Vol 3 (2) ◽  
pp. 50-54
Author(s):  
Mamatha B Patil ◽  
M Abhishek ◽  
BK Pradeep
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Airflow Obstruction ◽  
High Sensitivity ◽  
Chronic Obstructive ◽  
Clinical Parameters ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Hs Crp

ABSTRACT Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. By 2020, the World Health Organization predicts that COPD will become the third leading cause of death and the fifth leading cause of disability worldwide. The COPD is a complex disease characterized by slowly progressive and largely irreversible airflow obstruction due to chronic bronchitis and emphysema and associated with systemic inflammation. Objective This study aimed to correlate the plasma levels of high-sensitivity C-reactive protein (hs-CRP) with severity of COPD and pulmonary function tests [PFTs; according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages] and find out the relation between hs-CRP levels and clinical parameters of age, number of pack years, and body mass index (BMI) of the patient. Materials and methods A cross-sectional study of 102 male patients with clinically and spirometrically diagnosed cases of COPD was performed. Data on patient's demographic characteristics, pack years, BMI, PFTs, and hs-CRP were analyzed. Results A total of 76 of the patients had moderate airflow obstruction (GOLD stages II and III), mild airflow obstruction was present in 14 patients (GOLD stage I), and 12 patients had severe airflow obstruction (GOLD stage IV). The hs-CRP was normal in 6 patients, while it was raised in 96 patients. The value of hs-CRP was correlated with age, pack years, BMI, and GOLD stages. There was a significant negative correlation between hs-CRP and BMI and a significant positive correlation between hs-CRP and age, pack years, and GOLD stages. Conclusion A raised level of CRP in COPD indicates reduced lung function; it plays an important role in systemic inflammation. This study supports the role of hs-CRP as a simple, cost-effective biochemical marker in the staging and determining the severity of COPD other than spirometry. How to cite this article Patil MB, Abhishek M, Pradeep BK. Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters. J Med Sci 2017;3(2):50-54.

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