High-sensitivity C-reactive protein and 6-month all-cause mortality in Chinese heart failure patients

Heart failure (HF) is a principal cause of both morbidity and mortality throughout the world. As a marker of systemic inflammation, High - Sensitivity C - Reactive Protein (hs - CRP) is elevated in HF patients and is in relation with adverse clinical outcomes. However, the relationship between hs-CRP levels and mortality of HF patients, particularly in the Chinese population, remains incompletely characterized. In this retrospective cohort research, data from a prospective HF registry involving 941 patients who were hospitalized to the Zigong Fourth People's Hospital in Sichuan Province during January 2016 and December 2019 were analyzed. The primary endpoint was all-cause mortality within six months of admission. Because hs-CRP data did not follow a normal distribution, logarithmic transformation was carried out, and the values were stratified into tertiles to make the comparative analysis more convenient. Multivariable logistic regression, with adjustments made for potential confounding factors, was used to assess the independent prognostic value of log(hs-CRP). Constrained cubic spline transformations were used to investigate the potential nonlinear relationships between log(hs-CRP) and the risk of mortality. Among 941 selected participants, the six-month all-cause mortality rate was 3.08% (29/941). After adjusting for potential confounders, logistic regression analysis showed a significant positive association between elevated hs-CRP concentrations and increased mortality risk (OR = 2.073; 95% CI: 1.009-4.256; p = 0.047). Receiver operating characteristic curve analysis confirmed that hs-CRP has predictive value for mortality (AUC:0.66, 95%CI: 0.56-0.76), with an optimal cutoff value of 1.64. However, nonlinear association was not detected between these variables (log-rank p > 0.05). The study revealed a significant direct correlation between hs-CRP levels and six-month all-cause mortality in Chinese HF patients, suggesting that the biomarker may serve as a valuable prognostic indicator. These findings support the incorporation of hs-CRP measurement into routine evaluation protocols for heart failure patients to enhance risk stratification and guide therapeutic decision-making.