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C-Reactive Protein and All-Cause Mortality in Patients with Stable Coronary Artery Disease: A Secondary Analysis
Faxin Luo1, Caiyun Feng2, Chaozhou Zhuo1
1Emergency Department, The People's Hospital of Longhua, Shenzhen, Guangdong, China (mainland).
Insights
Elevated C-reactive protein (CRP) is linked to all-cause mortality (ACM) in patients with stable coronary artery disease (CAD). A CRP level of 0.345 mg/dL is the best diagnostic threshold for predicting ACM.
Area of Science:
- Cardiology
- Biomarkers
- Mortality Studies
Background:
- The relationship between C-reactive protein (CRP) and all-cause mortality (ACM) in stable coronary artery disease (CAD) requires further clarification.
- Understanding this association is crucial for risk stratification in CAD patients.
Purpose of the Study:
- To investigate the correlation between CRP levels and ACM in patients diagnosed with stable CAD.
- To determine the predictive value of CRP for ACM in this population.
Main Methods:
- Secondary analysis of data from 196 stable CAD patients (October 2014 - October 2017).
- Patients were categorized into four quartiles based on CRP concentration.
- All-cause mortality (ACM) was the primary outcome, tracked over a median follow-up of 783 days.
Main Results:
- A total of 18 deaths (9.18%) occurred during the follow-up period.
- Elevated CRP levels showed a significant association with ACM in both univariate and multivariate analyses (P<0.005).
- Pearson correlation indicated an association between elevated CRP and reduced left ventricular ejection fraction (LVEF) (r=-0.1936, P=0.0067).
Conclusions:
- Elevated C-reactive protein (CRP) is a significant predictor of all-cause mortality (ACM) in patients with stable coronary artery disease (CAD).
- The optimal diagnostic threshold for CRP to predict ACM in this cohort was identified as 0.345 mg/dL, with an Area Under the Curve (AUC) of 0.735.
Abstract:
BACKGROUND The association between C-reactive protein (CRP) and all-cause mortality (ACM) in patients with stable coronary artery disease (CAD) is unclear. Therefore, the aim of the present study was to explore the correlation between CRP and ACM in stable CAD patients. MATERIAL AND METHODS This study was a secondary analysis. Between October 2014 and October 2017, 196 patients aged 43 to 98 years who had a first diagnosis of stable CAD were recruited into this study. We divided the patients into 4 groups (Quartile 1: 0.01-0.03 mg/dL; Quartile 2: 0.04-0.11 mg/dL; Quartile 3: 0.12-0.33 mg/dL; and Quartile 4: 0.34-9.20 mg/dL) according to the concentration of CRP. The indicator surveyed in this research was ACM. RESULTS During a median follow-up of 783 days, ACM occurred in 18 patients, with a mortality rate of 9.18% (18/196). Univariate analysis showed that elevated CRP was closely related to ACM in stable CAD patients (P<0.005). After controlling for potential confounding factors by multivariate logistic regression analysis, this relationship still existed. Pearson correlation analysis showed that elevated CRP log10 transform was associated with LVEF (r=-0.1936, P=0.0067). Receiver operating characteristic (ROC) curve analysis showed that the optimal concentration of CRP for the diagnosis of ACM was 0.345, and the area under the curve (AUC) was 0.735. CONCLUSIONS Elevated CRP is associated with ACM in stable CAD patients, and the best diagnostic threshold is 0.345.
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