The short-term prognostic value of C-reactive protein in elderly patients with acute heart failure

Plasma c-reactive protein (crp) has been tested as a prognostic marker in acute heart failure (ahf). Whether its measurement really provides significant prognostic information when applied to elderly patients with ahf episodes remains unclear.

We measured the plasma crp values of patients admitted because of any type of ahf to internal medicine services. We evaluated the association of these values with the patients' baseline clinical characteristics and their 3-month posdischarge all-cause mortality or readmission rates. For comparison purposes, we divided the sample in tertiles of low, medium and high crp values (<2,24mg/l, 2,25-11,8mg/l and>11,8mg/l).

We included 1443 patients with a median age of 80 years (interquartile range 73-85); 680 (47%) were men, with a moderate comorbid burden. 60.1% had preserved left ventricular ejection fraction (> 50%). Multivariate analysis confirmed an independent association between higher crp values and the presence of respiratory infection, lower systolic blood pressure and deteriorated renal function upon admission. Three months after the index admission, a total of 142 patients (9.8%) had died, and 268 (18.6%) had either been readmitted or died. admission crp values did not correlate with 3-month all-cause mortality (P=0.79), 3-month all-cause readmission (P=0.96) or the combination of both events (P=0.96). However, higher crp values were associated with a longer length of stay (P<0.001).

Our study does not confirm an association between admission plasma crp values in elderly ahf patients and subsequent higher 3-month mortality or readmission risks.