Prediction of Mortality by High-Sensitivity C-Reactive Protein and Brain Natriuretic Peptide in Patients With Dilated Cardiomyopathy

Ishikawa, Chisato; Tsutamoto, Takayoshi; Fujii, Masazumi; Sakai, Hiroshi; Tanaka, Toshinari; Horie, Minoru

doi:10.1253/circj.70.857

Cited by 64 publications

(46 citation statements)

References 33 publications

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“…In addition, the prognostic power of hsCRP for cardiac death was independent of other prognostic factors evaluated in the present study. CRP and CHF: hsCRP is generated by the liver in response to various inflammatory stimuli and is a potent risk factor for coronary artery disease including acute myocardial infarction, 18,19) and for a poor prognosis for cardiovascular diseases, [20][21][22] dilated cardiomyopathy 23) and heart failure. 1,2) In a prospective cohort study of 6437 Dutch outpatients, CRP was found to predict incident heart failure in men, even after adjustment for traditional cardiovascular risk factors and comorbid coronary heart diseases.…”

Section: Discussionmentioning

confidence: 99%

High Sensitivity C-Reactive Protein Predicts Nonresponders and Cardiac Deaths in Severe Heart Failure Patients After CRT Implantation

et al. 2012

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SummaryThe purpose of this study was to determine whether high sensitivity C-reactive protein (hsCRP) before cardiac resynchronization therapy (CRT) implantation was able to predict the response to CRT and cardiac deaths in severe heart failure patients. The study population consisted of 65 heart failure patients (46 males, mean age 65.0 ± 11.8 years, NYHA class III/IV) with CRT implantation. Levels of hsCRP and B-type natriuretic peptide (BNP) were measured before CRT implantation. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), and left ventricular ejection fraction (LVEF) were assessed by echocardiography at the same time. At 6 months after device implantation follow-up, echocardiography was performed and reverse remodeling was defined as > 15% reduction in LVESV. Of the 61 patients (4 patients died within 6 months), 41 patients (67%) and 20 patients (33%) were classified as responders (group-R) and nonresponders (group-NR), respectively. Cardiac deaths occurred more frequently in group-NR than in group-R (29% versus 5%, P < 0.05). Hs-CRP level was significantly higher in group-NR than in group-R (P < 0.01). Multivariate logistic regression analysis showed an independent relationship between hsCRP and the incidence of nonresponders (odds ratio: 1.499, P = 0.011). Stepwise multivariate Cox proportional hazard analysis identified the hsCRP level as the strongest predictive factor for cardiac death (hazard ratio: 1.337, P = 0.001). Receiver operating characteristic (ROC) analysis revealed hsCRP levels of 3.0 mg/L as the cut-off value for cardiac mortality. The hsCRP level may provide a new insight into CRT implantation for severe heart failure by predicting responses to CRT and cardiac death. (Int Heart J 2012; 53: 306-312)

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Section: Discussionmentioning

confidence: 99%

High Sensitivity C-Reactive Protein Predicts Nonresponders and Cardiac Deaths in Severe Heart Failure Patients After CRT Implantation

et al. 2012

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“…More accurate assessment could be done using measurement of BNP in combination with other biomarkers, such as troponin T or C-reactive protein. 30 …”

Section: Bnp and Other Factorsmentioning

confidence: 99%

Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Seki

Tsurusaki

Kasai

et al. 2008

Circ J

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ypertension is widely recognized as a major risk factor for cardiovascular disease. 1,2 When initiating antihypertensive treatment, it is important to assess clinical characteristics and the severity of organ damage. [3][4][5] The plasma level of B-type natriuretic peptide (BNP) is well established as a useful marker of cardiac dysfunction, prognosis and response to treatment in patients with heart failure. [6][7][8][9] In patients with heart failure, secretion of BNP increases in proportion to the severity of left ventricular (LV) dysfunction, as indicated by the pulmonary capillary wedge pressure and LV end-diastolic pressure or the New York Heart Association class. 6,10 However, the measurement of BNP for clinical guidelines in hypertension is not recommended at present. 5 It has been reported that BNP is also increased in hypertensive patients without heart failure and in community residents with hypertension. 11-14 Hypertensive patients with cardiac hypertrophy have higher plasma BNP concentrations and the patients with increased BNP suffer from a higher incidence of cardiac events. 11,12 Recently, diastolic failure has attracted more attention in relation to hypertensive heart disease and this is associated with an increase in BNP. 15,16 Early and accurate diagnosis of diastolic failure is important to improve the prognosis of patients with heart failure. However, the role of BNP in the clinical assessment of hypertension has not been fully investigated and the actual meaning of a slight increase in BNP is still unclear. [11][12][13] The Framingham study demonstrated that an increase in BNP predicted the risk of death and cardiovascular events in community residents. 17 Neurohumoral factors become activated and play important roles in the pathophysiology of chronic heart disease. It would be helpful in general practice if BNP could be used as a marker of the risk of cardiovascular events in hypertensive patients.In the present study, we examined the relationship between plasma BNP levels and various clinical parameters to assess the usefulness of BNP as a marker for the severity of hypertension or organ damage in untreated hypertensives. The patients were clinically graded by BNP level. MethodsThe present study group comprised 154 persons with essential hypertension who attended our outpatient clinic (84 Circ J 2008; 72: 770 -777 (Received July 30, 2007; revised manuscript received October 22, 2007; accepted December 19, 2007 Methods and ResultsThe relationship between the plasma BNP level and various clinical parameters was examined in 154 untreated hypertensive patients without heart failure or atrial fibrillation (mean age: 58.0±10.7; mean blood pressure: 164.5±15.2/99.1±9.7 mmHg; mean BNP: 32.7±36.7 pg/ml). First, the patients were divided into 2 groups based on BNP: normal (<18.5 pg/ml, mean 9.7±5.7, n=69); or elevated (>18.5 pg/ml, mean 51.4± 40.4, n=85). The elevated BNP group had a significantly greater electrocardiographic voltage index (SV1+RV5; 3.7±1.2 vs 3.2±0.8 mV, p=0.0029), cardiothora...

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“…Its increased levels are considered a risk factor for atherosclerosis progression and complications even in healthy individuals (Dvorakova  Poledne, 2004). Increased levels of hsCRP were found also in patients with chronic heart failure, diastolic heart failure and dilated cardiomyopathy (Ishikawa et al, 2006;Michowitz et al, 2008;Xue et al, 2006). At least six major prospective studies support the hypothesis that elevated CRP levels contribute to increased cardiovascular risk (Devaraj et al, 2010;Ridker et al, 2000).…”

Section: Nonspecific Inflammatory Markers and Cardiovascular Diseasesmentioning

confidence: 98%

Inflammation and Genetics of Inflammation in Cardiovascular Diseases

Bucová¹

2011

Angina Pectoris

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Prediction of Mortality by High-Sensitivity C-Reactive Protein and Brain Natriuretic Peptide in Patients With Dilated Cardiomyopathy

Cited by 64 publications

References 33 publications

High Sensitivity C-Reactive Protein Predicts Nonresponders and Cardiac Deaths in Severe Heart Failure Patients After CRT Implantation

High Sensitivity C-Reactive Protein Predicts Nonresponders and Cardiac Deaths in Severe Heart Failure Patients After CRT Implantation

Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Inflammation and Genetics of Inflammation in Cardiovascular Diseases

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