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).
Cohort
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)?
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.
p-value: p=0.02
OBJECTIVES: Our aim was to investigate in a prospective study a potential role of C-reactive protein (CRP) in predicting the outcome in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). BACKGROUND: CRP is a well-known marker of inflammation and tissue damage, widely recognized as a risk predictor of cardiovascular and coronary heart diseases. METHODS: Plasma levels of CRP have been measured in consecutive patients diagnosed with PAH and CTEPH, at the time of right heart catheterization. RESULTS: Circulating CRP levels were increased in CTEPH and PAH patients compared with those in control subjects (4.9 mg l(-1), 95% confidence interval CI: 3.9 to 6.2 mg l(-1); 4.4 mg l(-1), 95% CI: 3.5 to 5.4 mg l(-1); and 2.3 mg l(-1), 95% CI: 1.9 to 2.7 mg l(-1), respectively; p 5.0 mg l(-1) had a significantly lower survival rate (p = 0.02, p = 0.009, and p < 0.05, respectively). In CTEPH patients, circulating CRP levels significantly decreased 12 months after pulmonary endarterectomy (n = 23, 4.0 mg l(-1), 95% CI: 2.8 to 5.8 mg l(-1), to 1.6 mg l(-1), 95% CI: 2.2 to 3.0 mg l(-1); p = 0.004). PAH patients normalizing their CRP levels under treatment (n = 29), assigned as responders, had a significantly higher survival rate (p < 0.05). The proportion of patients treated with a parenteral prostacyclin-analogue was significantly higher among the responders than the nonresponders (55% vs. 17%, p = 0.002). CONCLUSIONS: This is the first evidence of a role of an inflammatory marker, such as CRP, in predicting outcome and response to therapy in PAH.
Quarck et al. (Wed,) 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).
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