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C-Reactive protein in dilated cardiomyopathy
K Kaneko1, T Kanda, Y Yamauchi
1Second Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.
Insights
High C-reactive protein (CRP) levels in idiopathic dilated cardiomyopathy (DCM) patients indicate a poor prognosis. Measuring CRP can help identify high-risk individuals needing targeted treatment strategies for better outcomes.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation Research
Background:
- Idiopathic dilated cardiomyopathy (DCM) carries a poor prognosis with variable clinical presentations.
- Predicting individual patient outcomes in DCM is challenging using traditional laboratory data.
- Persistent myocardial inflammation may contribute to poor outcomes in some DCM patients.
Purpose of the Study:
- To investigate the association between plasma C-reactive protein (CRP) concentrations and patient outcomes in idiopathic DCM.
- To determine if CRP levels can serve as a valuable biomarker for risk stratification in DCM patients.
Main Methods:
- Plasma CRP concentrations were measured in 188 patients with idiopathic DCM over a 5-8 year follow-up period.
- Patients were categorized into two groups: early mortality (within 5 years) and long-term survivors (≥5 years).
- CRP levels were compared between the early mortality and long-term survivor groups.
Main Results:
- Patients who died within 5 years exhibited significantly higher CRP concentrations compared to long-term survivors (1.05 ± 1.37 vs. 0.49 ± 1.04 mg/dL, p < 0.05).
- A CRP level greater than 1.0 mg/dL was associated with a 62% mortality rate within 5 years.
- CRP measurement demonstrated value in identifying high-risk DCM patients.
Conclusions:
- Elevated plasma CRP levels are significantly associated with poor prognosis and early mortality in patients with idiopathic DCM.
- Routine CRP measurement, alongside other clinical assessments, is a valuable tool for identifying high-risk DCM patients.
- Identifying high-risk patients through CRP levels can guide the implementation of specialized treatment strategies to improve outcomes.
Abstract:
The prognosis for patients with idiopathic dilated cardiomyopathy (DCM) is poor, although clinical features are variable. Prediction of outcome has been difficult in individual patients based on laboratory data. In some patients with DCM, myocardial damage secondary to viral or immune-mediated myocardial inflammation may persist. To objectively assess inflammation, we measured plasma concentrations of C-reactive protein (CRP) in 188 patients with idiopathic DCM over 5-8 years. All had dyspnea and fatigue at rest; all patients had a left ventricular ejection fraction less than 40% by echocardiography or by contrast or radionuclide ventriculography. We divided these patients into two groups: patients dying within 5 years following admission (n = 49) and the remainder surviving for at least 5 years (n = 139). CRP concentrations in the patients dying early were significantly higher than in the long-term survivors (1. 05 +/- 1.37 vs. 0.49 +/- 1.04 mg/dl, p < 0.05). Sixty-two percent of the patients with CRP>1.0 died within 5 years. In addition to other laboratory tests including electrocardiography and echocardiography, routine CRP measurements proved to be valuable for identifying high-risk patients who require special treatment strategies.