High-sensitivity C-reactive protein in heart failure with preserved ejection fraction: Findings from TOPCAT.
Int J Cardiol
; 402: 131818, 2024 May 01.
Article
in En
| MEDLINE
| ID: mdl-38307421
ABSTRACT
BACKGROUND:
Inflammation plays a central role in the genesis and progression of heart failure with preserved ejection fraction (HFpEF). C-reactive protein (CRP) is widely used as means to assess systemic inflammation, and elevated levels of CRP have been associated with poor HF prognosis. Identification of chronic low-grade inflammation in outpatients can be performed measuring high-sensitivity CRP (hsCRP). The clinical characteristics and outcome associations of a pro-inflammatory state among outpatients with HFpEF requires further study.AIMS:
Using a biomarker subset of TOPCAT-Americas (NCT00094302), we aim to characterize HFpEF patients according to hsCRP levels and study the prognostic associations of hsCRP.METHODS:
hsCRP was available in a subset of 232 participants. Comparisons were performed between patients with hsCRP <2 mg/L and ≥ 2 mg/L. Cox regression models were used to study the association between hsCRP and the study outcomes.RESULTS:
Compared to patients with hsCRP <2 mg/L (n = 89, 38%), those with hsCRP ≥2 mg/L (n = 143, 62%) had more frequent HF hospitalizations prior to randomization, chronic obstructive pulmonary disease, orthopnea, higher body mass index, and worse health-related quality-of-life. A hsCRP level ≥ 2 mg/L was associated with an increased risk of cardiovascular death and HF hospitalizations hsCRP ≥2 mg/L vs <2 mg/L adjusted HR 2.36, 95%CI 1.27-4.38, P = 0.006. Spironolactone did not influence hsCRP levels from baseline to month 12 gMean ratio = 1.11, 95%CI 0.87-1.42, P = 0.39.CONCLUSIONS:
A hsCRP ≥2 mg/L identified HFpEF patients with a high risk of HF events and cardiovascular mortality. Spironolactone did not influence hsCRP levels at 12 months.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Heart Failure
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Int J Cardiol
Year:
2024
Type:
Article
Affiliation country:
France