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Predictive value of high sensitivity CRP in patients with diastolic heart failure
Yoav Michowitz1, Yaron Arbel, Dov Wexler
1The Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Insights
High-sensitivity C-reactive protein (hsCRP) is elevated in diastolic heart failure (HF) patients and correlates with disease severity. Further research is needed to establish its prognostic value in diastolic HF.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- C-reactive protein (CRP) has shown mixed predictive value in systolic heart failure (HF).
- The role of CRP in diastolic HF remains unclear.
- This study investigates the predictive role of high-sensitivity CRP (hsCRP) in diastolic HF.
Purpose of the Study:
- To determine the predictive role of hsCRP in patients with diastolic HF.
- To compare hsCRP levels in diastolic HF patients with systolic HF patients and healthy individuals.
- To assess the association of hsCRP with disease severity and clinical outcomes in diastolic HF.
Main Methods:
- HsCRP levels were measured in outpatients with diastolic HF (n=77) and systolic HF (n=217).
- HsCRP concentrations were compared to a large healthy cohort (n=7701).
- Associations with HF admissions, mortality, and New York Heart Association functional class (NYHA-FC) were analyzed.
Main Results:
- HsCRP levels were significantly elevated in both diastolic and systolic HF patients compared to healthy subjects, even after clinical adjustments (p<0.0001).
- In diastolic HF patients, hsCRP levels correlated with NYHA-FC (r=0.31, p=0.01).
- HsCRP independently predicted hospitalizations in systolic HF but not in diastolic HF on univariate analysis (p=0.047).
Conclusions:
- HsCRP concentrations are elevated in patients with diastolic HF.
- HsCRP levels correlate with disease severity in diastolic HF.
- The prognostic value of hsCRP in diastolic HF warrants further investigation.
Background:
C-reactive protein (CRP) has been tested in patients with systolic heart failure (HF) and mixed results have been obtained with regards to its potential predictive value. However, the role of C-reactive protein (CRP) in patients with diastolic HF is not established. We studied the predictive role of high sensitivity CRP (hsCRP) in patients with diastolic HF.
Methods:
HsCRP levels were measured in a cohort of CHF outpatients, 77 patients with diastolic HF and 217 patients with systolic HF. Concentrations were compared to a large cohort of healthy population (n=7701) and associated with the HF admissions and mortality of the patients.
Results:
Levels of hsCRP did not differ between patients with systolic and diastolic HF and were significantly elevated compared to the cohort of healthy subjects even after adjustment to various clinical parameters (p<0.0001). In patients with diastolic HF, hsCRP levels associated with New York Heart Association functional class (NYHA-FC) (r=0.31 p=0.01). On univariate Cox regression model hsCRP levels independently predicted hospitalizations in patients with systolic but not diastolic HF (p=0.047).
Conclusion:
HsCRP concentrations are elevated in patients with diastolic HF and correlate with disease severity; their prognostic value in this patient population should be further investigated.
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