Severe central sleep apnea in chronic heart failure patients was associated with significantly higher CRP levels compared to those without sleep-disordered breathing (0.893 vs 0.550 mg/dl, p<0.05).
Observational (n=966)
Is severe central sleep apnea associated with elevated C-reactive protein levels in patients with chronic heart failure?
Severe central sleep apnea in chronic heart failure patients is independently associated with elevated CRP levels, suggesting a link between sleep-disordered breathing and systemic inflammation.
Absolute Event Rate: 0.893% vs 0.55%
p-value: p=<0.05
BACKGROUND: Manifestation of central sleep apnea (CSA) with Cheyne-Stokes respiration is of major prognostic impact in chronic heart failure (CHF). Inflammatory processes have been linked to a progression of cardiovascular diseases, including heart failure. While an association of C-reactive protein (CRP) levels to obstructive sleep apnea has been documented before, there is a lack of information regarding variation of CRP levels in patients with CSA. OBJECTIVES: The objective of this study was to investigate a potential association of CRP levels to CSA severity in CHF patients. METHODS: High sensitivity CRP levels were analyzed in 966 patients with CHF (BMI 26.3 ± 4.6, New York Heart Association class 2.6 ± 0.5, left ventricular ejection fraction 29.4 ± 7.9%, N-terminal pro-brain natriuretic peptide, NT-proBNP, level 2,209 ± 3,315 pg/ml) without sleep-disordered breathing (SDB; Apnea-Hypopnea Index, AHI, <5/h) or various degrees of CSA, documented by in-hospital cardiorespiratory polygraphy or polysomnography. RESULTS: The CRP concentration in CHF patients was 0.550 ± 0.794 mg/dl in patients without SDB (AHI 0-4/h, n = 403) versus 0.488 ± 0.708 mg/dl in patients with mild CSA (AHI 5-14/h, n = 123, p = n.s.) and 0.660 ± 0.963 mg/dl in patients with moderate CSA (AHI 15-29/h, n = 160, p = n.s.). In patients with severe CSA (AHI ≥ 30/h, n = 280), significantly higher CRP concentrations were documented (0.893 ± 1.384 mg/dl, p < 0.05). Stepwise regression analysis revealed AHI, NT-proBNP and heart rate to be independently associated with elevated CRP levels. CONCLUSION: Severe CSA in CHF patients is associated with elevated levels of CRP, a systemic marker of inflammation and cardiovascular risk. This might explain in part the negative prognostic impact of CSA in these patients.
Schmalgemeier et al. (Wed,) conducted a observational in Chronic heart failure (n=966). Severe central sleep apnea vs. No sleep-disordered breathing was evaluated on High sensitivity CRP levels (p=<0.05). Severe central sleep apnea in chronic heart failure patients was associated with significantly higher CRP levels compared to those without sleep-disordered breathing (0.893 vs 0.550 mg/dl, p<0.05).