Related Experiment Video
Updated: Aug 11, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Long-Term Trajectories of High-Sensitivity C-Reactive Protein Level Among Patients with Acute Heart Failure
Guangda He1, Runqing Ji1, Xiqian Huo1
1National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People's Republic of China.
Insights
Persistent high inflammation is linked to increased mortality in heart failure (HF) patients. Identifying distinct inflammatory trajectories, like persistently high or very high, is crucial for understanding HF outcomes and guiding treatment strategies.
Area of Science:
- Cardiology
- Inflammation Research
- Biomarkers
Background:
- Inflammation plays a role in heart failure (HF) progression.
- Long-term inflammatory patterns and their impact on acute HF patient outcomes are not well understood.
Purpose of the Study:
- To identify distinct inflammatory trajectories in patients with acute heart failure.
- To investigate the association between these inflammatory trajectories and long-term mortality.
Main Methods:
- Utilized data from the China Patient-Centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.
- Employed latent class trajectory modeling to characterize high-sensitivity C-reactive protein (hsCRP) levels over time.
- Applied multivariable Cox regression to analyze the relationship between hsCRP trajectories and mortality.
Main Results:
- Identified four distinct inflammatory trajectories among 1281 patients: persistently low (32.7%), very high with marked decrease (7.7%), persistently high (50.7%), and persistently very high (8.9%).
- Compared to the persistently low trajectory, persistently high (HR: 1.59) and persistently very high (HR: 2.56) trajectories were associated with significantly increased all-cause mortality.
- The very high but decreasing trajectory showed no significant increase in mortality (HR: 0.94).
Conclusions:
- Four distinct inflammatory trajectories were identified in acute heart failure patients surviving over 12 months.
- Persistently high and very high inflammatory trajectories are significantly associated with increased mortality risk.
- These findings highlight the prognostic value of inflammatory patterns in heart failure management.
Background:
Inflammation contributes to the progression of heart failure (HF). However, long-term inflammatory trajectories and their associations with outcomes in patients with acute HF remain unclear.
Methods:
Data was obtained from the China Patient-Centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study, and high-sensitivity C-reactive protein (hsCRP) was used to reflect the inflammatory level. Only patients who survived over 12-month and had hsCRP data at admission, 1-, and 12-month after discharge were included. The latent class trajectory modeling was used to characterize hsCRP trajectories. Multivariable Cox regression models were used to explore the association between hsCRP trajectories and following mortality.
Results:
Totally, 1281 patients with a median 4.77 (interquartile range [IQR]: 4.24-5.07) years follow-up were included. The median age was 64 years (IQR: 54-73 years); 453 (35.4%) were female. Four distinct inflammatory trajectories were characterized: persistently low (n = 419, 32.7%), very high-marked decrease (n = 99, 7.7%), persistently high (n = 649, 50.7%), and persistently very high (n = 114, 8.9%). Compared with the persistently low trajectory, the all-cause mortality was increased in a graded pattern in the persistently high (hazard ratio [HR]: 1.59, 95% confidence interval [CI]: 1.23-2.07) and persistently very high (HR: 2.56, 95% CI: 1.83-3.70) trajectories; nevertheless, the mortality was not significantly increased in very high-marked decrease trajectory (HR: 0.94, 95% CI: 0.57-1.54).
Conclusion:
Four distinct inflammatory trajectories were identified among patients with acute HF who survived over 12-month. Patients with persistently high and very high trajectories had significantly higher mortality than those with the persistently low trajectory.
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
07:40Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
Published on: October 10, 2019
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...
01:30Acute Coronary Syndrome III: 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...
01:29Heart Failure II: Pathophysiology
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:23Rheumatic Heart Disease I: Introduction