Tzu Chi Medical Journal
Volume 21, Issue 4 , Pages 296-301, December 2009

High-sensitivity C-reactive Protein and Other Factors as Outcome Predictors in Acute Decompensated Heart Failure

  • Chih-Wei Chen

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • College of Medicine, Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Division of Cardiology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, 2, Min-Sheng Road, Chiayi, Taiwan
    • ,
  • Yen-Hsien Lee

      Affiliations

    • College of Medicine, Tzu Chi University, Hualien, Taiwan
    • Division of Thoracic Medicine, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Hung-Mei Chen

      Affiliations

    • Department of Medical Education, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Ying-Lung Lin

      Affiliations

    • Department of Family Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

Received 20 February 2009; received in revised form 10 April 2009; accepted 22 May 2009.

Article Outline

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.

Keywords:  Acute decompensated heart failure , Hs-CRP , Risk predictor

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PII: S1016-3190(09)60059-8

doi:10.1016/S1016-3190(09)60059-8

Tzu Chi Medical Journal
Volume 21, Issue 4 , Pages 296-301, December 2009

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