Related Experiment Video
Updated: Dec 5, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Prognostic value of C-reactive protein in adults with congenital heart disease
Laurie W Geenen1, Vivan J M Baggen1, Annemien E van den Bosch1
1Cardiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights
High-sensitivity C reactive protein (hs-CRP) offers additional prognostic information for death or heart failure (HF) in adult congenital heart disease (ACHD) patients, independent of other biomarkers. Rising hs-CRP levels precede clinical deterioration, highlighting inflammation
Area of Science:
- Cardiology
- Biomarkers
- Inflammation Research
Background:
- Adult congenital heart disease (ACHD) patients face unique long-term health challenges.
- High-sensitivity C reactive protein (hs-CRP) is a known inflammation marker associated with cardiovascular outcomes.
- The independent prognostic value of hs-CRP in ACHD, beyond established biomarkers like NT-proBNP and troponin T, remains unclear.
Purpose of the Study:
- To investigate the temporal changes in hs-CRP levels in ACHD patients.
- To determine if hs-CRP provides prognostic value for adverse outcomes (death or heart failure) independent of NT-proBNP and troponin T.
- To explore the role of inflammation in the clinical deterioration of ACHD.
Main Methods:
- Prospective cohort study of 602 ACHD patients (2011-2013) with annual blood sampling over 4 years.
- Measurement of hs-CRP, hs-troponin T, and NT-proBNP.
- Cox regression and Joint Modelling to assess the association between hs-CRP and the composite endpoint of death or heart failure, adjusting for baseline and repeated measures of other biomarkers.
Main Results:
- Higher baseline hs-CRP was independently associated with an increased risk of death or heart failure (HR 1.36).
- Hs-CRP levels showed a significant increase over time preceding the occurrence of death or heart failure.
- Repeated hs-CRP measurements demonstrated prognostic value independent of NT-proBNP and hs-troponin T (HR 1.54).
Conclusions:
- Hs-CRP provides incremental prognostic value for predicting death or heart failure in ACHD patients, beyond NT-proBNP and hs-troponin T.
- The observed increase in hs-CRP before adverse events supports a role for inflammation in the clinical decline of ACHD.
- Hs-CRP may serve as a valuable biomarker for risk stratification and monitoring in ACHD.
Background:
High-sensitivity C reactive protein (hs-CRP) has been associated with outcomes in adult congenital heart disease (ACHD). However, its prognostic value beyond N-terminal pro B type natriuretic peptide (NT-proBNP) or troponin T remains unknown. We studied the temporal evolution of hs-CRP, as well as the relation between hs-CRP and adverse clinical outcomes independent of NT-proBNP and troponin T in patients with ACHD.
Methods:
In this prospective cohort study, we enrolled 602 patients with ACHD (2011-2013) who underwent baseline and thereafter annual blood sampling during 4 years. Hs-CRP, hs-troponin T and NT-proBNP were measured. The primary endpoint was composed of death or heart failure (HF). Cox regression and Joint Modelling was used to relate 2log hs-CRP levels with the endpoint, with adjustment for baseline characteristics and (repeated) hs-troponin T and NT-proBNP measurements.
Results:
Hs-CRP was measured at baseline in 591 patients, median age 33 years, 58% men, 90% New York Heart Association I with an average of 4.3 measurements per patient. Median follow-up was 5.9 (IQR 5.3-6.3) years (99.2% complete) and 69 patients met the endpoint. Higher baseline hs-CRP was independently associated with higher risk of death or HF (HR 1.36, 95% CI 1.19 to 1.55). Hs-CRP increased over time prior to death or HF, and repeated hs-CRP measurements were associated with the endpoint, independent of repeated NT-proBNP and hs-troponin T (HR 1.54, 95% CI 1.24 to 1.98).
Conclusions:
Hs-CRP carries incremental prognostic value for the risk of death or HF, beyond NT-proBNP and hs-troponin T. Hs-CRP increased prior to the occurrence of HF or death, supporting the role of inflammation in the clinical deterioration of patients with ACHD.
More Related Videos
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:23Rheumatic Heart Disease I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Rheumatic Heart Disease IV: Nursing Management