High-sensitivity C-reactive protein as a prognostic marker in patients undergoing valve surgery

Introduction: An inflammatory reaction is a local or systemic response of the organs or tissues of the body to many damaging factors.One of the exponents of the inflammatory process is C-reactive protein (CRP).Aim: To investigate the prognostic value of C-reactive protein (CRP) in patients undergoing valve surgery.Material and methods: A prospective study was conducted on a group of consecutive patients with haemodynamically significant valve defects who underwent elective valve repair or replacement surgery.The primary end-point was in-hospital death from all causes.Patients were followed by direct observation during hospitalization.The risk of surgery using Euro-SCORE II was calculated for each patient.The plasma levels of C-reactive protein were measured by the Cardiac C-Reactive Protein (Latex) High Sensitive Test (Roche, Germany).Results: The study group included 562 patients.The mean age in the studied population was 63 (standard deviation (SD) ±12).The mean plasma preoperative CRP level was 0.39 ±0.3 mg/dl.The primary endpoint occurred in 25 patients.At multivariate analysis age (p = 0.01), CRP (p = 0.02) and NT-proBNP (p = 0.03) remained independent predictors of the primary endpoint.A significant correlation was found between the level of CRP and haemoglobin (r = -0.3;p < 0.0001), red cell distribution width (r = 0.22; p < 0.0001), ejection fraction (r = -0.24,p = 0.007), troponin T (r = 0.3; p < 0.0001), creatinine (r = 0.26; p = 0.001) and body mass index (r = -0.29;p = 0.005).The average total time of hospitalization after the operation in patients with occurrence of the primary endpoint was 25 ±13 days.Conclusions: Elevated preoperative CRP was associated with a poorer outcome following valve surgery.