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Predictive value of high sensitivity C-reactive protein in the diagnosis and outcomes of acute aortic syndromes
  1. Soufian T AlMahameed1,
  2. Gian M Novaro2,
  3. Craig R Asher2,
  4. Penny L Hougthaling3,
  5. Rodrigo M Lago2,
  6. Deepak L Bhatt4,
  7. Amjad T AlMahameed5,
  8. Eric J Topol6
  1. 1Carilion Clinic and Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, Virginia, USA
  2. 2Department of Cardiology, Cleveland Clinic Florida, Weston, Florida, USA
  3. 3Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
  4. 4VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
  5. 5Interventional Cardiology and Vascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  6. 6The Scripps Research Institute and Scripps Clinic, La Jolla, California, USA
  1. Correspondence to Dr Gian M Novaro, Cleveland Clinic Florida, Department of Cardiology, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA; novarog{at}ccf.org

Abstract

Objective The purpose of this study was to determine whether high-sensitivity C-reactive protein (hsCRP) levels differ among patients with acute aortic syndromes (AAS) and if hsCRP could predict their long-term outcomes.

Design Retrospective observational study.

Setting Cleveland Clinic Hospital, Cleveland, Ohio.

Patients 115 consecutive patients with AAS admitted to the cardiac intensive care unit.

Interventions HsCRP and other laboratory data were measured within 24 h of admission. Demographic, imaging and laboratory data were obtained at the time of presentation. For the long-term survival analysis, the social security death index was used to determine all-cause mortality.

Main outcome measures HsCRP levels among AAS patients.

Results Hospital mortality was 4.3% for AAS patients. HsCRP levels differed significantly among AAS; the median hsCRP was higher in the aortic dissection group (49 mg/l) than in those with penetrating aortic ulcer (28 mg/l), symptomatic aortic aneurysm (14 mg/l), and intramural haematoma (10 mg/l); (p=0.02). In multivariable analysis, aortic dissection patients had higher hsCRP levels than intramural haematoma (p=0.03) and symptomatic aortic aneurysm (p=0.04) patients, after adjusting for age and gender. Multivariable Cox regression analyses showed that elevated hsCRP levels at presentation were associated with a higher long-term mortality (p=0.007).

Conclusions Among patients with AAS, those with aortic dissection have the highest hsCRP levels at presentation. Elevated hsCRP independently predicted a higher long-term mortality in AAS patients.

  • C Reactive protein
  • aortic diseases
  • aneurysm
  • dissecting
  • inflammation
  • aortic root disease
  • biochemical markers
  • cytokines
  • outcomes
  • vascular heart disease
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Footnotes

  • Funding DLB receives research support from Astra Zeneca, Bristol-Myers Squibb, Eisai, Ethicon, Heartscape, Sanofi Aventis and The Medicines Company.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Cleveland Clinic Ethics Review Board, Cleveland, Ohio.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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