Mildly elevated high-sensitivity C-reactive protein (10 to 15 mg/L) was associated with a 2-fold increased risk of 3-year mortality (HR 2.00) compared to normal levels (<2 mg/L) in patients with suspected acute coronary syndrome.
Cohort (n=102,337)
Yes
Does mildly elevated hsCRP predict mortality risk beyond troponin in patients with suspected ACS?
Mildly elevated hsCRP is an independent predictor of 3-year mortality in patients with suspected ACS, providing prognostic value beyond troponin.
Effect estimate: HR 2.00 (95% CI 1.75 to 2.28)
BACKGROUND: There is limited evidence on the use of high-sensitivity C-reactive protein (hsCRP) as a biomarker for selecting patients for advanced cardiovascular (CV) therapies in the modern era. The prognostic value of mildly elevated hsCRP beyond troponin in a large real-world cohort of unselected patients presenting with suspected acute coronary syndrome (ACS) is unknown. We evaluated whether a mildly elevated hsCRP (up to 15 mg/L) was associated with mortality risk, beyond troponin level, in patients with suspected ACS. METHODS AND FINDINGS: We conducted a retrospective cohort study based on the National Institute for Health Research Health Informatics Collaborative data of 257,948 patients with suspected ACS who had a troponin measured at 5 cardiac centres in the United Kingdom between 2010 and 2017. Patients were divided into 4 hsCRP groups (15 mg/L makes it unlikely that sepsis was a major contributor. CONCLUSIONS: These multicentre, real-world data from a large cohort of patients with suspected ACS suggest that mildly elevated hsCRP (up to 15 mg/L) may be a clinically meaningful prognostic marker beyond troponin and point to its potential utility in selecting patients for novel treatments targeting inflammation. TRIAL REGISTRATION: ClinicalTrials.gov - NCT03507309.
Kaura et al. (Tue,) conducted a cohort in Suspected acute coronary syndrome (n=102,337). Mildly elevated hsCRP (10-15 mg/L) vs. Normal hsCRP (<2 mg/L) was evaluated on All-cause mortality at 3 years (HR 2.00, 95% CI 1.75 to 2.28). Mildly elevated high-sensitivity C-reactive protein (10 to 15 mg/L) was associated with a 2-fold increased risk of 3-year mortality (HR 2.00) compared to normal levels (<2 mg/L) in patients with suspected acute coronary syndrome.