C-reactive protein, diastolic dysfunction, and risk of heart failure in patients with coronary disease: Heart and...

Area of Science:

• Cardiology
• Inflammation Research
• Clinical Medicine

Background:

• High-sensitivity C-reactive protein (CRP) is a known predictor of coronary heart disease (CHD).
• Recent studies suggest CRP also predicts incident heart failure (HF).
• The relationship between inflammation and HF, mediated by left ventricular dysfunction or CHD, remains unclear.

Purpose of the Study:

• To investigate whether inflammation, indicated by CRP, predicts heart failure hospitalizations in patients with established CHD.
• To determine if this association is explained by baseline left ventricular dysfunction or underlying coronary heart disease.

Main Methods:

• Serum CRP levels were measured in 985 outpatients with established CHD.
• Participants were followed for 3 years for hospitalisation due to HF.
• Multivariate analysis adjusted for traditional risk factors, CHD severity, myocardial infarction (MI), and diastolic dysfunction.

Main Results:

• 15% of patients with elevated CRP (>3 mg/L) were hospitalised for HF versus 7% with lower CRP levels.
• Elevated CRP was associated with HF hospitalization after adjusting for traditional risk factors, CHD severity, and interim MI (aHR 2.1).
• This association was no longer significant after adjusting for diastolic dysfunction (aHR 1.6).

Conclusions:

• Elevated CRP levels predict heart failure hospitalisation in stable CHD outpatients, independent of other factors.
• The predictive value of CRP for HF in this cohort is at least partly explained by the presence of diastolic dysfunction.
• Inflammation, as measured by CRP, may contribute to HF development through impaired cardiac function.