Proteína C-reativa: marcador inflamatório com valor prognóstico em pacientes com insuficiência cardíaca descompensada

Villacorta, Humberto; Masetto, Antonio Claudio; Mesquita, Evandro Tinoco

doi:10.1590/s0066-782x2007000500014

Cited by 41 publications

(15 citation statements)

References 24 publications

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“…To our knowledge, few studies have evaluated the prognostic significance of the CRP/albumin ratio in patients treated with EGDT, whereas many studies have investigated the use of inflammatory markers, such as CRP, procalcitonin, and pro-BNP to predict mortality in critically ill patients [ 13 , 19 , 20 ]. Among these markers, CRP is readily accessible in the critical care setting, and its value as a prognostic marker is proven in many diseases, including cerebral disease, heart failure, and sepsis [ 11 , 12 , 21 ]. However, these studies mainly focused on 28- to 30-day mortality.…”

Section: Discussionmentioning

confidence: 99%

The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

et al. 2015

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BackgroundSepsis, including severe sepsis and septic shock, is a major cause of morbidity and mortality. Albumin and C-reactive protein (CRP) are considered as good diagnostic markers for sepsis. Thus, initial CRP and albumin levels were combined to ascertain their value as an independent predictor of 180-day mortality in patients with severe sepsis and septic shock.Materials and MethodsWe conducted a retrospective cohort study involving 670 patients (>18 years old) who were admitted to the emergency department and who had received a standardized resuscitation algorithm (early goal-directed therapy) for severe sepsis and septic shock, from November 2007 to February 2013, at a tertiary hospital in Seoul, Korea. The outcome measured was 180-day all-cause mortality. A multivariate Cox proportional hazard model was used to identify the independent risk factors for mortality. A receiver operating characteristic (ROC) curve analysis was conducted to compare the predictive accuracy of the CRP/albumin ratio at admission.ResultsThe 180-day mortality was 28.35% (190/670). Based on the multivariate Cox proportional hazard analysis, age, the CRP/albumin ratio at admission (adjusted HR 1.06, 95% CI 1.03–1.10, p<0.001), lactate level at admission (adjusted HR 1.10, 95% CI 1.05–1.14, p<0.001), and the Sequential Organ Failure Assessment (SOFA) score at admission (adjusted HR 1.12, 95% CI 1.07–1.18, p<0.001) were independent predictors of 180-day mortality. The area under the curve of CRP alone and the CRP/albumin ratio at admission for 180-day mortality were 0.5620 (P<0.001) and 0.6211 (P<0.001), respectively.ConclusionThe CRP/albumin ratio was an independent predictor of mortality in patients with severe sepsis or septic shock.

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Section: Discussionmentioning

confidence: 99%

The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

et al. 2015

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“…In the Brazilian study, conducted with the aim of examining the prognostic significance of CRP in subjects hospitalised for HF, patients with CRP values over 3 mg/dL had an increased mortality. In a multivariate analysis, CRP was found to be the most important independent prognostic factor (17). …”

Section: Discussionmentioning

confidence: 99%

Association Between the Inflammatory Biomarkers and Left Ventricular Systolic Dysfunction in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease

Andrijević¹,

Milutinov²,

Andrijević³

et al. 2017

Balkan Med J

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Background:Cardiovascular diseases are an important cause of morbidity and mortality in chronic obstructive pulmonary disease patients. The increased inflammatory biomarker levels predict exacerbations and are associated with cardiovascular diseases in stable chronic obstructive pulmonary disease patients but their role in the settings of acute chronic obstructive pulmonary disease exacerbations has not been determined.Aims:To analyse the association between inflammatory biomarkers and heart failure and also to determine the predictors of mortality in patients with exacerbations of chronic obstructive pulmonary disease.Study Design:Prospective observational study.Methods:We analysed 194 patients admitted for acute exacerbation of chronic obstructive pulmonary disease at The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. In all patients, C-reactive protein, fibrinogen, N-terminal of the pro-hormone brain natriuretic peptide and white blood count were measured and transthoracic echocardiography was performed.Results:There were 119 men (61.3%) and the median age was 69 years (interquartile range 62-74). Left ventricular systolic dysfunction (ejection fraction <50%) was present in 47 (24.2%) subjects. Patients with left ventricular systolic dysfunction had higher C-reactive protein levels (median 100 vs. 31 mg/L, p=0.001) and fibrinogen (median 5 vs. 4 g/L, p=<0.001) compared to those with preserved ejection fraction. The overall hospital mortality was 8.2% (16/178). The levels of C-reactive protein, fibrinogen, N-terminal pro-brain natriuretic peptide and ejection fraction predicted hospital mortality in univariate analysis. After adjusting for age, hypoxemia and C-reactive protein, ejection fraction remained significant predictors of hospital mortality (OR 3.89, 95% CI 1.05-15.8).Conclusion:Nearly a quarter of patients with the exacerbation of chronic obstructive pulmonary disease present with left ventricular systolic dysfunction which may be associated with mortality.

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“…Elevated levels of CRP, ST-2, galectin-3, and IL-6 have all been correlated with increased rates of mortality in patients diagnosed with ADHF [3, 12, 26, 28, 30, 32, 39, 41]. Of note, the majority of these studies compared the utility of inflammatory biomarkers to natriuretic peptides with respect to the predictive accuracy for diagnosing heart failure in dyspneic patients.…”

Section: Elevated Levels Of Inflammatory Mediators Correlate With Dismentioning

confidence: 99%

Positioning of Inflammatory Biomarkers in the Heart Failure Landscape

Hartupee

Mann

2013

J. of Cardiovasc. Trans. Res.

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The clinical syndrome of heart failure is characterized by a systemic inflammatory response that contributes to end organ damage in the heart and circulation and can thus lead to worsening heart failure. The ensemble of inflammatory mediators that have been detected in heart failure patients include pro-inflammatory cytokines and their cognate receptors, as well as molecules secreted/released by macrophages (galectin-3 and pentraxin-3). Inflammatory biomarkers correlate with disease severity and prognosis across the broad spectrum of heart failure syndromes. Given the proliferation of new biomarkers that predict disease severity and prognosis in heart failure, it is reasonable to ask whether there is a current role for measuring inflammatory mediators in heart failure. This review will attempt to address this question, as well as review several novel approaches that have utilized inflammatory biomarkers to enhance risk stratification and prognosis in heart failure patients.

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Proteína C-reativa: marcador inflamatório com valor prognóstico em pacientes com insuficiência cardíaca descompensada

Abstract: SummaryBackground: Inflammation has been implicated in the pathophysiology of a series of cardiovascular diseases. C-reactive protein (CRP) is a marker of inflammation easily obtained in the emergency room.

Cited by 41 publications

References 24 publications

The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

Association Between the Inflammatory Biomarkers and Left Ventricular Systolic Dysfunction in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease

Positioning of Inflammatory Biomarkers in the Heart Failure Landscape

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