High-sensitivity C-reactive Protein and Other Factors as Outcome Predictors in Acute Decompensated Heart Failure
Received 20 February 2009; received in revised form 10 April 2009; accepted 22 May 2009.
Abstract
Objective
Patients with acute decompensated heart failure (ADHF) have high mortality and rehospitalization rates. Although circulating levels of high-sensitivity C-reactive protein (hs-CRP) are an accurate prognostic factor in chronic heart failure, no data are available to indicate whether hs-CRP can predict outcomes in patients with ADHF.
Materials and Methods
We prospectively evaluated serum hs-CRP levels, patient characteristics, laboratory data, medications and management during hospitalization and two end points (inhospital mortality and 6-month readmission rate for heart failure) in 80 patients who presented with ADHF.
Results
No correlation was found between initial hs-CRP at admission and the two end points. The result was the same for all patients after excluding those in whom infection was a predisposing factor for ADHF. Cardiogenic shock significantly predicted inhospital mortality (odds ratio [OR] = 15.76; 95% confidence interval [CI] = 1.8–180.06; p = 0.026). A high serum peak creatinine level (OR = 1.39; 95% CI = 0.98–1.98; p = 0.064) and ischemic heart disease as the etiology of heart failure ((OR = 2.48; 95% CI = 0.93–6.58; p = 0.068) could predict 6-month readmission with borderline significance.
Conclusion
Hs-CRP may have no value as a predictor of the outcomes of inhospital mortality and 6-month readmission for heart failure in ADHF. Many clinical factors such as cardiogenic shock were found to be associated with inhospital mortality, and high serum peak creatinine levels and ischemic heart disease as the etiology of heart failure were found to be associated with 6-month readmission. Therefore, early detection of these high-risk groups to predict inhospital outcomes is possible.
No full text is available. To read the body of this article, please view the PDF online.
aDivision of Cardiology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
bCollege of Medicine, Tzu Chi University, Hualien, Taiwan
cDivision of Thoracic Medicine, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
dDepartment of Medical Education, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
eDepartment of Family Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
Corresponding author. Division of Cardiology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, 2, Min-Sheng Road, Chiayi, Taiwan
ABSTRACT