Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure
Background Elevated hsCRP (high‐sensitivity C‐reactive protein) level is associated with worse prognosis among patients hospitalized for heart failure. However, the prognostic value of the long‐term cumulative hsCRP remains unknown. Methods and Results We consecutively enrolled patients hospitalized...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-10-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.029386 |
| _version_ | 1797387409784045568 |
|---|---|
| author | Lihua Zhang Guangda He Xiqian Huo Aoxi Tian Runqing Ji Boxuan Pu Yue Peng |
| author_facet | Lihua Zhang Guangda He Xiqian Huo Aoxi Tian Runqing Ji Boxuan Pu Yue Peng |
| author_sort | Lihua Zhang |
| collection | DOAJ |
| description | Background Elevated hsCRP (high‐sensitivity C‐reactive protein) level is associated with worse prognosis among patients hospitalized for heart failure. However, the prognostic value of the long‐term cumulative hsCRP remains unknown. Methods and Results We consecutively enrolled patients hospitalized for heart failure and collected their hsCRP data at admission and 1 and 12 months after discharge. Long‐term cumulative hsCRP was evaluated using 2 approaches, cumulative hsCRP level quartiles and cumulative times of high hsCRP levels. Patients were classified into 4 groups by cumulative hsCRP level quartiles and cumulative times of high hsCRP levels (0‐ to 3‐times: number of times that hsCRP levels were higher than cutoff values at admission or 1 or 12 months), respectively. Multivariable Cox models were used to assess the association of mortality with cumulative hsCRP. A total of 1281 patients were included; the median age was 64 (interquartile range, 54–73) years, and 35.4% were women. Over a 4.8‐year (interquartile range, 4.2–5.1) follow‐up, 374 (29.2%) patients died. Elevated long‐term cumulative hsCRP level was related to higher mortality. Specifically, taking the quartile 1 as the reference, the hazard ratios (HRs) were 1.29 (95% CI, 0.92–1.81) for quartile 2, 1.62 (95% CI, 1.16–2.25) for quartile 3, and 2.38 (95% CI, 1.75–3.23) for quartile 4. Similarly, compared with the patients with 0‐times (hsCRP level lower than the cutoff values in all 3 time points) of high hsCRP level, the HRs were 1.36 for 1‐time (hsCRP level higher than the cutoff value in one of the 3 time points) (95% CI, 0.92–2.01), 1.95 for 2‐times (hsCRP levels higher than the cutoff values in 2 of the 3 time points) (95% CI, 1.34–2.82), and 2.80 for 3‐times (hsCRP levels higher than the cutoff values in the 3 time points) (95% CI, 1.97–4.00). Conclusions Increasing long‐term cumulative hsCRP level was associated with worse outcomes in patients hospitalized for acute heart failure. Repeated hsCRP measurements could assist physicians in identifying patients with a high risk of death. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT 02878811. |
| first_indexed | 2024-03-08T22:23:42Z |
| format | Article |
| id | doaj.art-a1f280f6d77240f48123e09d41cd3cb3 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-08T22:23:42Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-a1f280f6d77240f48123e09d41cd3cb32023-12-18T11:20:28ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-10-01121910.1161/JAHA.123.029386Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart FailureLihua Zhang0Guangda He1Xiqian Huo2Aoxi Tian3Runqing Ji4Boxuan Pu5Yue Peng6National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaNational Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaNational Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaNational Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaNational Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaNational Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaNational Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People’s Republic of ChinaBackground Elevated hsCRP (high‐sensitivity C‐reactive protein) level is associated with worse prognosis among patients hospitalized for heart failure. However, the prognostic value of the long‐term cumulative hsCRP remains unknown. Methods and Results We consecutively enrolled patients hospitalized for heart failure and collected their hsCRP data at admission and 1 and 12 months after discharge. Long‐term cumulative hsCRP was evaluated using 2 approaches, cumulative hsCRP level quartiles and cumulative times of high hsCRP levels. Patients were classified into 4 groups by cumulative hsCRP level quartiles and cumulative times of high hsCRP levels (0‐ to 3‐times: number of times that hsCRP levels were higher than cutoff values at admission or 1 or 12 months), respectively. Multivariable Cox models were used to assess the association of mortality with cumulative hsCRP. A total of 1281 patients were included; the median age was 64 (interquartile range, 54–73) years, and 35.4% were women. Over a 4.8‐year (interquartile range, 4.2–5.1) follow‐up, 374 (29.2%) patients died. Elevated long‐term cumulative hsCRP level was related to higher mortality. Specifically, taking the quartile 1 as the reference, the hazard ratios (HRs) were 1.29 (95% CI, 0.92–1.81) for quartile 2, 1.62 (95% CI, 1.16–2.25) for quartile 3, and 2.38 (95% CI, 1.75–3.23) for quartile 4. Similarly, compared with the patients with 0‐times (hsCRP level lower than the cutoff values in all 3 time points) of high hsCRP level, the HRs were 1.36 for 1‐time (hsCRP level higher than the cutoff value in one of the 3 time points) (95% CI, 0.92–2.01), 1.95 for 2‐times (hsCRP levels higher than the cutoff values in 2 of the 3 time points) (95% CI, 1.34–2.82), and 2.80 for 3‐times (hsCRP levels higher than the cutoff values in the 3 time points) (95% CI, 1.97–4.00). Conclusions Increasing long‐term cumulative hsCRP level was associated with worse outcomes in patients hospitalized for acute heart failure. Repeated hsCRP measurements could assist physicians in identifying patients with a high risk of death. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT 02878811.https://www.ahajournals.org/doi/10.1161/JAHA.123.029386cumulative high‐sensitivity C‐reactive proteinheart failuremortalityprognosis |
| spellingShingle | Lihua Zhang Guangda He Xiqian Huo Aoxi Tian Runqing Ji Boxuan Pu Yue Peng Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cumulative high‐sensitivity C‐reactive protein heart failure mortality prognosis |
| title | Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure |
| title_full | Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure |
| title_fullStr | Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure |
| title_full_unstemmed | Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure |
| title_short | Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure |
| title_sort | long term cumulative high sensitivity c reactive protein and mortality among patients with acute heart failure |
| topic | cumulative high‐sensitivity C‐reactive protein heart failure mortality prognosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.029386 |
| work_keys_str_mv | AT lihuazhang longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure AT guangdahe longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure AT xiqianhuo longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure AT aoxitian longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure AT runqingji longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure AT boxuanpu longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure AT yuepeng longtermcumulativehighsensitivitycreactiveproteinandmortalityamongpatientswithacuteheartfailure |