Association of hs-CRP Levels and Medications Adherence Status among Heart Failure Patients at a Cardiac Referral Hospital in Tanzania
Introduction: Heart Failure (HF) is a global health problem, and despite much progress in new therapies, its prognosis remains poor. This is due to a number of factors including lack of adherence to HF medications. Previous studies have shown high sensitivity C-reactive protein (hsCRP) to change...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14884/47582_CE[Ra]_F(Sh)_PF1(AkA_OM)_PFA(AKA_KM)_PN(KM).pdf |
| Summary: | Introduction: Heart Failure (HF) is a global health problem,
and despite much progress in new therapies, its prognosis
remains poor. This is due to a number of factors including lack
of adherence to HF medications. Previous studies have shown
high sensitivity C-reactive protein (hsCRP) to change with
HF progression, and that plasma hsCRP levels can be used
to predict HF progression and assessment of adherence to
medications. This association however has not been studied in
Sub-Saharan African (SSA) countries, including Tanzania.
Aim: To study the association between hsCRP levels and HF
medications adherence among HF patients attending the Jakaya
Kikwete Cardiac Institute (JKCI) in Dar es Salaam, Tanzania.
Materials and Methods: This was a hospital based crosssectional study, where all eligible adult HF patients were
consecutively enrolled as they attended their regular clinics,
until the sample size was reached. Patients’ socio-demographic
and clinical information was collected through interviews and
chart reviews. An 8-item Morisky tool was used to assess
patients’ adherence to HF medications. Blood was collected
and analysed for hsCRP, Complete Blood Count (CBC) and
cholesterol panel. hsCRP was considered elevated when it
was >5 mg/L. Data were analysed using Statistical Package
for Social Sciences (SPSS) computer software, version 21. All
tests were 2-sided, and a p-value of <0.05 was considered to
indicate a significant association.
Results: In total, 210 HF patients were enrolled. Their mean
age was 54±15.9 years and 53.8% were females. In the total
population, the mean hsCRP was 7.15±4.94 mg/L, and 122
(58.1%) patients had elevated hsCRP. Poor medications
adherence was present in 138 (65.7%) patients. Patients with
poor medications adherence were more likely to have elevated
hsCRP levels (68.1%) when compared to patients with good
adherence (38.9%), p<0.001. In multivariate logistic regression
analysis, elevated hsCRP independently predicted poor
medications adherence (OR=4.27, 95% CI 2.14-8.51, p<0.001),
irrespective of other variables.
Conclusion: HF patients with poor medications adherence are
4-times more likely to have elevated hsCRP, irrespective of other
clinical and socio-demographic factors in this study cohort.
These findings suggest that hsCRP levels can be considered as
surrogate to HF medications adherence. |
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| ISSN: | 2249-782X 0973-709X |