Prognostic value of high-sensitivity C-reactive protein in patients with chronic heart failure.

OBJECTIVE To determine whether high-sensitivity C-reactive protein (hsCRP) has prognostic value in patients with chronic heart failure. METHODS Serum hsCRP levels were measured with high-sensitivity assay (IMMAGE Immunochemistry Systems) in 128 patients with CHF and 25 healthy control subjects. Cardiac troponin T (TNT) was measured by electrochemiluminescence immunoassay on an Elecsys1010 automatic analyser. Cardiac events were defined as cardiac death and rehospitalisation because of worsening heart failure during the follow-up period. RESULTS Circulating levels of hsCRP and TNT were significantly higher in patients with CHF than in the 25 healthy people (p=0.0028, p=0.017, respectively) and increased with severity of CHF. During a mean follow-up period of 378 +/- 26 days, 42 (32.8%) of the 128 patients had cardiac events. Levels of hsCRP and TNT were significantly higher (p=0.00031, p=0.00047, respectively) and LVEF was significantly lower (p=0.0052) in patients with cardiac events than in patients without cardiac events. When multivariate Cox proportional hazards regression was performed, we found that hsCRP, TNT, and LVEF were independent significant predictors of cardiac events in patients with CHF (hsCRP: hazard ratio [HR], 3.81; 95% confidence interval [CI], 2.14-9.35; p=0.024; TNT: HR, 2.61; 95%CI, 1.96-4.31; p=0.012; LVEF: HR, 3.52; 95%CI, 2.36-10.37; p=0.024). When Pearson's correlation analyses were performed, we could find a positive correlation between hsCRP and TNT (r=0.493, p=0.0043) and a negative correlation between hsCRP and LVEF(r=-0.354, p=0.0051). CONCLUSION Serum hsCRP concentrations were elevated in patients with CHF and increased with severity of CHF. It was an independent significant predictor of cardiac events in patients with CHF.