C-reactive protein, not cardiac troponin T, improves risk prediction in hypertensives with type A aortic dissection

Vrsalović, Mislav; Zeljković, Ivan; Presečki, Ana Vrsalović; Pintarić, Hrvoje; Krušlin, Božo

doi:10.3109/08037051.2015.1025607

Cited by 22 publications

(29 citation statements)

References 18 publications

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“…Furthermore, AAD patients with higher inflammatory cell activity in the aortic wall seemed to have a high risk for disease progression and poorer prognosis in the acute phase [ 14 ]. Moreover, several inflammatory markers such as interleukin-6 (IL-6), C-reactive protein (CRP), matrix metalloproteinases-9 (MMP-9), and WBC at admission were reportedly associated with the severity of systemic inflammatory response and adverse outcomes in patients with type A AAD [ 13 , 15 - 19 ]. Similarly, high WBC at admission, platelet to lymphocyte ratio, and neutrophil to lymphocyte ratio were correlated with increased in-hospital mortality risk for type B AAD [ 20 - 22 ].…”

Section: Discussionmentioning

confidence: 99%

Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection

et al. 2017

Oncotarget

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BackgroundInflammation and thrombosis are associated with development and progression of acute aortic dissection (AAD). The aim of this study was to assess the prognostic significance of Simplified Thrombo-Inflammatory Prognostic Score (sTIPS), in patients with early phase type B AAD.MethodsWe retrospectively reviewed 491 patients with type B AAD between November 2012 and September 2015. sTIPS was calculated from the white blood cell count (WBC) and mean platelet volume to platelet count (MPV/PC) ratio, at the time of admission. Patients with both, WBC > 10 (109/L) and MPV/PC ratio > 7.5 (102fL/109L-1) were assigned a score of 2, while patients with high levels of either one or none of the above markers, were assigned scores of 1 and 0 respectively. Multivariable Cox regression analyses were used to investigate the associations between the score and hospital survival.ResultsOf the 491 type B AAD patients included in this analysis, 24 patients (4.9%) died during hospitalization. Kaplan-Meier analysis revealed that the cumulative mortality was significantly higher in patients with higher sTIPS (P = 0.001). Multivariable Cox regression analysis further indicated that higher sTIPS was a strong predictor of in-hospital mortality after eliminating all confounding factors (sTIPS 2: hazard ratio 4.704, 95%; confidence interval [CI] 1.184-18.685; P = 0.028; sTIPS 1: hazard ratio 1.918, 95%; CI 1.134-3.537; P = 0.045).ConclusionssTIPS at admission was a useful tool for stratifying the risk in type B AAD patients, for outcomes such as in-hospital mortality in the early phase.

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Section: Discussionmentioning

confidence: 99%

Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection

et al. 2017

Oncotarget

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“…As a marker of inflammation, CRP is closely related to many CVDs such as hypertension, atherosclerosis, coronary heart disease, and myocardial infarction. Increased CRP levels correlate with the development of false lumen thrombosis in AAD patients [ 16 ], which is an independent risk factor for predicting mortality [ 17 , 18 ]. TSP-1 is a multifunctional glycoprotein widely distributed in blood, heart, cartilage, lung, and brain and it is involved in important physiological processes.…”

Section: Discussionmentioning

confidence: 99%

Acute Aortic Dissection Biomarkers Identified Using Isobaric Tags for Relative and Absolute Quantitation

Xiao

Xue

Yao

et al. 2016

BioMed Research International

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The purpose of this study was to evaluate the utility of potential serum biomarkers for acute aortic dissection (AAD) that were identified by isobaric Tags for Relative and Absolute Quantitation (iTRAQ) approaches. Serum samples from 20 AAD patients and 20 healthy volunteers were analyzed using iTRAQ technology. Protein validation was performed using samples from 120 patients with chest pain. A total of 355 proteins were identified with the iTRAQ approach; 164 proteins reached the strict quantitative standard, and 125 proteins were increased or decreased more than 1.2-fold (64 and 61 proteins were up- and downregulated, resp.). Lumican, C-reactive protein (CRP), thrombospondin-1 (TSP-1), and D-dimer were selected as candidate biomarkers for the validation tests. Receiver operating characteristic (ROC) curves show that Lumican and D-dimer have diagnostic value (area under the curves [AUCs] 0.895 and 0.891, P < 0.05). For Lumican, the diagnostic sensitivity and specificity were 73.33% and 98.33%, while the corresponding values for D-dimer were 93.33% and 68.33%. For Lumican and D-dimer AAD combined diagnosis, the sensitivity and specificity were 88.33% and 95%, respectively. In conclusion, Lumican has good specificity and D-dimer has good sensitivity for the diagnosis of AAD, while the combined detection of D-dimer and Lumican has better diagnostic value.

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“…While CRP is well studied in acute coronary and acute aortic syndromes ( 1 , 15 , 16 ), its prognostic role in symptomatic PAD is still controversial ( 5 ). In line with our results, Owens et al showed independent prognostic value of CRP (>5 mg/L) for all-cause mortality in PAD patients undergoing bypass surgery ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

Vrsalović

Vučur²,

Car

et al. 2015

Croat Med J

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AimTo investigate the prognostic role of C-reactive protein (CRP) and renal function for the occurrence of major adverse cardiovascular events (MACE) in patients with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF).MethodsThe occurrence of MACE, defined as composite endpoint of acute myocardial infarction, urgent coronary revascularization, stroke, and death was assessed in 319 consecutive PAD patients admitted to the University Hospital between January 2010 and January 2014 (66.5% men, mean [±standard deviation] age 70 ± 10 years, mean ankle brachial index 0.58 ± 0.14) with normal LVEF (>50%). Multivariate Cox regression analysis adjusted for age, sex, traditional cardiovascular risk factors, anemia, polyvascular disease, critical limb ischemia (CLI), statin treatment, CRP (>5 mg/L), and impaired renal function (estimated glomerular filtration rate <60 mL/min) was applied to assess the independent predictors of MACE.ResultsDuring median follow-up period of 24 months (interquartile range, 16-34 months), 77 patients (24%) experienced MACE. Compared to patients without MACE, these patients were older, more likely to have CLI, polyvascular disease, anemia, elevated CRP, and impaired renal function. In multivariate regression analysis, age (HR 1.04, 95% CI 1.01-1.07), polyvascular disease (HR 1.95, 95% CI 1.23-3.09), elevated CRP (HR 1.89, 95% CI 1.18-3.02), and impaired renal function (HR 1.68, 95% C 1.01-2.78) remained independent predictors of MACE. Patients with both impaired renal function and high CRP values on admission were 3.59 times more likely to experience MACE than patients with normal CRP and preserved renal function.ConclusionElevated admission CRP and renal impairment are independent predictors of MACE in symptomatic PAD patients with preserved LVEF.

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C-reactive protein, not cardiac troponin T, improves risk prediction in hypertensives with type A aortic dissection

Abstract: Admission CRP has independent prognostic value in type A AAD and the addition of CRP to IRAD score improved discriminative capacity of in-hospital mortality irrespective of symptom duration and treatment strategy.

Cited by 22 publications

References 18 publications

Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection

Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection

Acute Aortic Dissection Biomarkers Identified Using Isobaric Tags for Relative and Absolute Quantitation

C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

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