C-Reactive Protein at Hospital Discharge and 1-Year Mortality in Acute Infective Endocarditis: A Prospective...

Area of Science:

• Cardiology
• Infectious Diseases
• Biomarkers

Background:

• Acute infective endocarditis (IE) requires accurate biomarkers for risk stratification at hospital discharge.
• C-reactive protein (CRP) is a potential biomarker for predicting mortality in IE patients.
• This study investigates the prognostic value of CRP in hospitalized IE patients.

Purpose of the Study:

• To evaluate the prognostic value of C-reactive protein (CRP) levels at hospital discharge.
• To identify patients with acute infective endocarditis (IE) at high risk of mortality.
• To assess the association of CRP with 1-year mortality and secondary endpoints like rehospitalization or paravalvular abscess.

Main Methods:

• A prospective observational study enrolled 343 patients with acute IE from two university-affiliated medical centers.
• Patients were categorized into low or high CRP groups based on a discharge CRP cutoff of 6.5 mg/L.
• Primary endpoint was all-cause mortality; secondary endpoints included rehospitalization or paravalvular abscess within 1 year.

Main Results:

• The high-CRP group exhibited significantly higher 1-year mortality (21.43%) compared to the low-CRP group (2.76%).
• High CRP levels were associated with a 4.182-fold increased hazard risk for mortality.
• The incidence of paravalvular abscess was significantly higher in the high-CRP group (11.90%) versus the low-CRP group (5.07%).

Conclusions:

• Elevated CRP levels at hospital discharge are a strong indicator of poor prognosis in acute IE patients.
• High CRP is associated with increased 1-year mortality and a higher risk of developing paravalvular abscess.
• CRP serves as a valuable biomarker for identifying high-risk IE patients requiring closer post-discharge management.