High-sensitivity C-reactive Protein (hsCRP) and Heart Failure

High-sensitivity C-reactive protein (hsCRP) has long been recognized as a marker of inflammation in various medical contexts. Among patients hospitalized for heart failure, elevated hsCRP levels at admission have been associated with worse outcomes. However, a recent study delves deeper into the long-term cumulative effects of hsCRP levels on the prognosis of heart failure patients.

The study results were published in the Journal of the American Heart Association.

Study Overview

The study enrolled a total of 1281 patients who were hospitalized for heart failure. These patients were monitored at admission and at 1 and 12 months after discharge to collect hsCRP data. The researchers employed two approaches to assess long-term cumulative hsCRP levels: quartiles of cumulative hsCRP levels and cumulative instances of high hsCRP levels. Patients were categorized into four groups based on these criteria.

A total of 1281 patients with a median age of 64 (interquartile range, 54–73) years were included. Of these, 35.4% were women. During a follow-up period averaging 4.8 years, 374 (29.2%) patients passed away. The study found a compelling link between elevated long-term cumulative hsCRP levels and increased mortality risk.

Findings

• When compared to quartile 1 (used as a reference), the hazard ratios (HRs) for mortality were:
  • 1.29 (95% CI, 0.92–1.81) for quartile 2
  • 1.62 (95% CI, 1.16–2.25) for quartile 3
  • 2.38 (95% CI, 1.75–3.23) for quartile 4
  demonstrating a progressively higher mortality risk with increasing quartiles of cumulative hsCRP levels.
• Likewise, patients were grouped based on the cumulative times their hsCRP levels exceeded cutoff values:
  • HR of 1.36 (95% CI, 0.92–2.01) for 1-time
  • HR of 1.95 (95% CI, 1.34–2.82) for 2-times
  • HR of 2.80 (95% CI, 1.97–4.00) for 3-times
  which suggests a substantial increase in mortality risk with each additional instance of high hsCRP levels.

Conclusion

Thus, the study's findings underscore the significance of long-term cumulative hsCRP levels in predicting outcomes for patients hospitalized for acute heart failure. Monitoring hsCRP levels over time could assist physicians in identifying patients at a higher risk of mortality. Early identification and intervention for patients with elevated long-term hsCRP levels may offer a valuable tool in improving their prognosis and overall care.

Further Reading

Further reading: Long‐Term Cumulative High‐Sensitivity C‐Reactive Protein and Mortality Among Patients With Acute Heart Failure. Journal of the American Heart Association. 2023;12:e029386.

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