C-reactive Protein (CRP) in Patients With Myocarditis: A Systematic Review and Meta-Analysis
Bushra Ghulam1, Zahira Bashir2, Amber Khurshid Akram3
1Biochemistry, Islamic International Medical College, Islamabad, PAK.
Insights
C-reactive protein (CRP) levels are significantly higher in myocarditis patients compared to healthy individuals. This finding suggests CRP could be a valuable biomarker for diagnosing and predicting myocarditis outcomes.
Area of Science:
- Cardiology
- Biomarkers
- Inflammatory Diseases
Background:
- Myocarditis, an inflammation of the heart muscle, can be fatal and requires early diagnosis.
- Current diagnostic methods for myocarditis are often complex or machine-dependent.
- C-reactive protein (CRP) is a known indicator of inflammation in the body.
Purpose of the Study:
- To investigate the correlation between C-reactive protein (CRP) levels and myocarditis.
- To assess the potential of CRP as a diagnostic biomarker for myocarditis.
Main Methods:
- A systematic literature search was conducted across PubMed, Google Scholar, and ScienceDirect.
- Four eligible studies were selected for meta-analysis, comparing CRP levels in myocarditis patients versus healthy controls.
- Study quality, bias, outliers, sensitivity, significance, and heterogeneity were evaluated.
Main Results:
- A significant mean difference (MD) of 6.03 (95% CI: 2.41-9.64, p<0.00001) was observed, indicating elevated CRP in myocarditis patients.
- High study quality and no significant bias or outliers were noted.
- High heterogeneity (I²=99%) was present, but a fixed-effect model confirmed the significant elevation (MD: 5.08 (95% CI: 4.85-5.32)).
Conclusions:
- Elevated C-reactive protein (CRP) levels are strongly associated with myocarditis.
- CRP shows potential as a reliable biomarker for accurate diagnosis and prognosis of myocarditis.
- Further research can validate CRP's role in clinical settings for myocarditis management.
Abstract:
Myocarditis is a type of cardiovascular disease related to inflammation of cardiac muscle which can be even fatal to some extent. Early and simple diagnosis is crucial for this complication; however, complex or machine-based methods, such as histological tests, x-rays, electrocardiograms, etc., are usually used for its detection. C-reactive protein (CRP) is a biomarker that naturally elevates during inflammation. Therefore, we tried to understand the correlation between CRP and myocarditis. We primarily identified 451 studies from PubMed, Google Scholar, and ScienceDirect and ultimately selected four studies as eligible. We identified the mean difference (MD) in CRP levels between the myocarditis patients and healthy controls. The study quality, outliers, sensitivity, significance, and heterogeneity were also checked. The MD (6.03 (95%CI: 2.41-9.64), p<0.00001) corresponds to a higher and significant CRP level in myocarditis as compared to the control group. The study quality was found to be high with no bias or outliers and the heterogeneity was also determined to be high (I2=99%). Using the fixed effect model, the forest plot determined a similar result as the main outcome (MD: 5.08 (95%CI: 4.85-5.32)) proving higher sensitivity and reproducibility. These findings indicated the possibility of CRP being an established biomarker for an accurate diagnosis and prognosis of myocarditis.
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