Mortality risk prediction of high-sensitivity C-reactive protein in suspected acute coronary syndrome: A cohort study

Area of Science:

• Cardiology
• Biomarkers
• Inflammation

Background:

• Limited evidence exists on high-sensitivity C-reactive protein (hsCRP) as a biomarker for advanced cardiovascular therapies.
• The prognostic value of mildly elevated hsCRP beyond troponin in acute coronary syndrome (ACS) is largely unknown.
• This study investigates hsCRP's association with mortality risk in suspected ACS patients.

Purpose of the Study:

• To evaluate if mildly elevated hsCRP (up to 15 mg/L) is associated with mortality risk.
• To determine if this association is independent of troponin levels.
• To explore hsCRP's potential as a prognostic marker in ACS.

Main Methods:

• Retrospective cohort study of 102,337 patients with suspected ACS (2010-2017).
• Patients categorized into four hsCRP groups (<2, 2-4.9, 5-9.9, 10-15 mg/L).
• Multivariable Cox regression analysis assessed 3-year all-cause mortality, adjusted for clinical factors and troponin.

Main Results:

• A graded relationship observed between hsCRP levels and mortality risk at baseline and 3 years.
• Hazard ratios for mortality increased with hsCRP levels (e.g., 2.00 for 10-15 mg/L group).
• This association remained significant and independent of troponin levels in suspected ACS patients.

Conclusions:

• Mildly elevated hsCRP (up to 15 mg/L) is a clinically meaningful prognostic marker in suspected ACS.
• hsCRP may aid in identifying patients who could benefit from novel anti-inflammatory treatments.
• Real-world data support hsCRP's utility beyond troponin for risk stratification in ACS.