Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure

Kavsak, Peter A.; MacRae, Andrew R.; Newman, Alice; Lustig, Viliam; Palomaki, Glenn E.; Ko, Dennis T.; Tu, Jack V.; Jaffe, Allan S.

doi:10.1016/j.clinbiochem.2006.10.025

Cited by 51 publications

(40 citation statements)

References 21 publications

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“…CRP, as the inflammatory marker, was the important predictor of cardiovascular events and prognosis [4][5][6]. However, it is unclear and controversial about whether CRP directly participates in endothelial dysfunction and atherogenesis.…”

Section: Discussionmentioning

confidence: 99%

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CRP regulates the expression and activity of tissue factor as well as tissue factor pathway inhibitor via NF‐κB and ERK 1/2 MAPK pathway

et al. 2009

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Edited by Beat Imhof Keywords:Human umbilical vein endothelial cell C-reactive protein Tissue factor Tissue factor pathway inhibitor a b s t r a c t It was found that C-reactive protein (CRP) could significantly increase the expression and activity of tissue factor (TF), but decrease that of tissue factor pathway inhibitor (TFPI) in human umbilical vein endothelial cells (HUVECs) in dose-and time-dependent manners, which could be antagonized by PDTC and U0126. CRP could also increase protein expression of phosphorylated nuclear factor-kappaB (NF-jB), IjB-a and ERK1/2 in dose-and time-dependent manner. In addition, neutralizing antibody to CD32 (FcgammaR II) could significantly attenuate the expression and activity of TF and TFPI induced by CRP. These results suggest that CRP may promote coagulation by enhancing the expression and activity of TF and reducing that of TFPI by activating NF-jB and extracellular signal-regulated kinase via FcgammaR II.

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Section: Discussionmentioning

confidence: 99%

“…C-reactive protein (CRP), the prototypic marker of inflammation, in addition to being a risk marker, can also act as the important predictive factor for cardiac events [4][5][6]. In addition, it was demonstrated that injecting highly purified CRP into humans could activate the blood coagulation system [7,8].…”

Section: Introductionmentioning

confidence: 99%

CRP regulates the expression and activity of tissue factor as well as tissue factor pathway inhibitor via NF‐κB and ERK 1/2 MAPK pathway

et al. 2009

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“…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. 6) In the Valsartan Heart Failure Trial (Val-Heft), CRP was an independent predictor of mortality and morbidity in patients with established heart failure (CRP > 3.23 mg/L, HR 1.23, 95% CI: 1.05-1.44, P = 0.009).…”

Section: Discussionmentioning

confidence: 99%

“…1,2) Among biomarkers of inflammatory status, C-reactive protein (CRP) is the most widely used predictor of worse clinical outcomes. [3][4][5][6] Cardiac resynchronization therapy (CRT) is a well established treatment for patients with severe heart failure despite optimal medical treatment. Many studies have demonstrated that CRT improves exercise capacity, quality of life, New York Heart Association (NYHA) functional class, mortality in heart failure patients with impaired left ventricular (LV) systolic function, and intraventricular conduction delay.…”

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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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“…The study population has been previously described in detail [5][6][7]. In brief, following research ethics board approval, subjects (n=216) from our ACS study population (448 patients originally recruited in 1996) were selected if there were at least 2 EDTA specimens available in storage (−70 °C) per subject.…”

Section: Methodsmentioning

confidence: 99%

Vascular versus myocardial dysfunction in acute coronary syndrome: Are the adhesion molecules as powerful as NT-proBNP for long-term risk stratification?

Kavsak

Newman

et al. 2008

Clinical Biochemistry

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Objectives-To determine if elevations of adhesion molecules in acute coronary syndrome (ACS) are useful for risk stratification.Design and methods-A cell adhesion array (Randox Ltd.) and NT-proBNP were measured in 216 ACS patients.Results-Kaplan-Meier and Cox models indicate early elevations of NT-proBNP but not the adhesion molecules are predictive of future death/myocardial infarction.Discussion-Elevations of adhesion molecules early after pain onset in ACS are not useful for long-term risk stratification.

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Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure

Cited by 51 publications

References 21 publications

CRP regulates the expression and activity of tissue factor as well as tissue factor pathway inhibitor via NF‐κB and ERK 1/2 MAPK pathway

CRP regulates the expression and activity of tissue factor as well as tissue factor pathway inhibitor via NF‐κB and ERK 1/2 MAPK pathway

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

Vascular versus myocardial dysfunction in acute coronary syndrome: Are the adhesion molecules as powerful as NT-proBNP for long-term risk stratification?

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