April 22, 2026Journal of the American College of Cardiology
C-Reactive Protein
Key result
Elevated CRP is linked to lower survival in patients with PAH.
- P=0.02
Why the study?
Although CRP is a known marker of inflammation and cardiovascular risk predictor, its potential role in predicting outcomes in PAH and CTEPH required prospective investigation.
Do plasma C-reactive protein (CRP) levels predict outcomes and response to therapy in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH)?
Key Points
- This research aims to explore the predictive value of C-reactive protein in the outcomes of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.
- Measured plasma CRP levels in patients diagnosed with PAH and CTEPH during right heart catheterization.
- Analyzed correlation of CRP levels with clinical parameters and survival rates.
- Evaluated changes in CRP levels post pulmonary endarterectomy.
- CRP levels were significantly higher in PAH and CTEPH patients compared to controls (p < 0.0001).
- Higher CRP levels correlated with worse functional class and right atrial pressure in PAH patients (p = 0.003 for survival).
- Responders who normalized CRP levels had a significantly higher survival rate (p < 0.05) and more were treated with prostacyclin-analogue (55% vs. 17%, p = 0.002).
Study Design
Type
Cohort
Structured PICO
Do plasma C-reactive protein (CRP) levels predict outcomes and response to therapy in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH)?
P
Population
Patients diagnosed with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and control subjects.
I
Intervention
Measurement of plasma C-reactive protein (CRP) levels at the time of right heart catheterization.
C
Comparator
Control subjects, and comparison between patients with high versus low CRP levels.
O
Outcome
Survival rate and correlation with clinical parameters (New York Heart Association functional class, right atrial pressure, and 6-min walking distance).hard clinical
Main Result
p-value: p=0.02
Elevated C-reactive protein levels correlate with disease severity and predict poorer survival in patients with pulmonary arterial hypertension, and decrease following successful pulmonary endarterectomy in CTEPH.
Authors
Discussion
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Implication
CRP may aid PAH risk stratification; leaves open if anti-inflammatory therapies improve survival.
Cite This Study
Quarck et al. (2009) conducted a cohort in Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). C-reactive protein (CRP) vs. Control subjects / CRP ≤5.0 mg/L was evaluated on Survival rate (p=0.02). Elevated C-reactive protein levels (>5.0 mg/L) were associated with a significantly lower survival rate in patients with pulmonary arterial hypertension (p=0.02).