Prognostic value of C-reactive protein as an inflammatory and N-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean Heart Failure registry)
- PMID: 24315115
- DOI: 10.1016/j.amjcard.2013.10.022
Prognostic value of C-reactive protein as an inflammatory and N-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean Heart Failure registry)
Abstract
The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3%) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4%, Q2 9.5%, Q3 16.9%, Q4 19.3%, p <0.001) and NT-proBNP quartiles (Q1 7.0%, Q2 13.4%, Q3 11.6%, Q4 20.4%, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95% confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95% CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95% CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF.
Copyright © 2014 Elsevier Inc. All rights reserved.
Similar articles
-
Incremental value of high-sensitivity C-reactive protein and N-terminal pro-B-type natriuretic peptide for the prediction of postoperative cardiac events in noncardiac vascular surgery patients.Coron Artery Dis. 2009 May;20(3):219-24. doi: 10.1097/MCA.0b013e3283219e47. Coron Artery Dis. 2009. PMID: 19322079
-
Amino-terminal pro-B-type natriuretic peptide and high-sensitivity C-reactive protein but not cystatin C predict cardiovascular events in male patients with peripheral artery disease independently of ambulatory pulse pressure.Am J Hypertens. 2014 Mar;27(3):363-71. doi: 10.1093/ajh/hpt278. Epub 2014 Jan 27. Am J Hypertens. 2014. PMID: 24470529
-
Combined use of high-sensitivity cardiac troponin T and N-terminal pro-B type natriuretic peptide improves measurements of performance over established mortality risk factors in chronic heart failure.Am Heart J. 2012 May;163(5):821-8. doi: 10.1016/j.ahj.2012.03.004. Am Heart J. 2012. PMID: 22607860
-
A Systematic Review and Meta-Analysis of Advanced Biomarkers for Predicting Incident Cardiovascular Disease among Asymptomatic Middle-Aged Adults.Int J Mol Sci. 2022 Nov 4;23(21):13540. doi: 10.3390/ijms232113540. Int J Mol Sci. 2022. PMID: 36362325 Free PMC article. Review.
-
The Role of Troponin for Acute Heart Failure.Curr Heart Fail Rep. 2019 Feb;16(1):21-31. doi: 10.1007/s11897-019-0420-5. Curr Heart Fail Rep. 2019. PMID: 30762176 Review.
Cited by
-
Reappraisal of Inflammatory Biomarkers in Heart Failure.Curr Heart Fail Rep. 2020 Feb;17(1):9-19. doi: 10.1007/s11897-019-00450-1. Curr Heart Fail Rep. 2020. PMID: 31916187 Free PMC article. Review.
-
Hemodynamic, management, and outcomes of patients admitted to emergency department with heart failure.Scand J Trauma Resusc Emerg Med. 2016 Nov 7;24(1):132. doi: 10.1186/s13049-016-0324-2. Scand J Trauma Resusc Emerg Med. 2016. PMID: 27821147 Free PMC article.
-
Mortality after admission for heart failure in the UK compared with Japan.Open Heart. 2018 Sep 11;5(2):e000811. doi: 10.1136/openhrt-2018-000811. eCollection 2018. Open Heart. 2018. PMID: 30228905 Free PMC article.
-
Temporal Trends of Hospitalized Patients with Heart Failure in Korea.Korean Circ J. 2017 Jan;47(1):16-24. doi: 10.4070/kcj.2016.0429. Epub 2016 Dec 29. Korean Circ J. 2017. PMID: 28154584 Free PMC article. Review.
-
Prognostic importance of emerging cardiac, inflammatory, and renal biomarkers in chronic heart failure patients with reduced ejection fraction and anaemia: RED-HF study.Eur J Heart Fail. 2018 Feb;20(2):268-277. doi: 10.1002/ejhf.988. Epub 2017 Sep 27. Eur J Heart Fail. 2018. PMID: 28960777 Free PMC article. Clinical Trial.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous