Prognostic significance of C-Reactive protein and its correlation with predictors of outcome in stable and unstable patients of COPD

Abstract

Aim- The aim of the study was to find out value of CRP in COPD patients and its correlation with the predictors of outcome. Method- We studied 100 COPD patients (80 stable and 20 unstable) with spirometry, body mass index, MMRDC dyspnoea scale, 6-minute walk distance and BODE index. The CRP values were measured in these patients and compared with 50 sex and age matched controls. CRP was subjected to evaluation for any correlation with the predictors of outcomes in COPD patients. Results- Serum CRP levels were significantly higher in COPD patients than in healthy subjects (Mean 13.55+10.83 vs.2.07+ 0.82 mg/lit, p<0.001). CRP levels were significantly higher in unstable than stable patients (mean 33.78+7.74 mg/lit vs. 8.50+1.81 mg/lit, p<0.001). Severity of dyspnoea as measured by MMRC dyspnoea scale was significantly higher in unstable patients than in stable patients (mean 3.60+0.5 vs. 1.84+0.86, p<0.001). The exercise capacity of the patients as measured by 6 MWD was significantly lower in un stable patients than in stable patients (mean 180.5+53.26m vs. 219.58+67m, p=0.017). The BODE index was found to be significantly higher among unstable patients than stable patients (mean 7.30+1.66 vs. 4.94+1.94, p<0.001). A significant negative correlation was found between CRP and FEV1 (r=-0.284, p=0.004) and FEV1/FVC (r=-0.305, p=0.002). CRP levels were independent of FVC (r=-0.162, p=0.107). A significant positive correlation was found bet ween CRP and severity of dyspnoea according to MMRC dyspnoea scale (r=0.638, p<0.001). The CRP levels negatively correlated with the exercise capacity of the patient (6MWD) which was statistically significant (r= -0.364, p<0.001). A significant positive correlation was foun d between CRP with BODE index (r=0.780, p<0.001) and BODE stage (r=0.726, p<0.001). Conclusion- We conclude that systemic inflammation is present in COPD patients and CRP is important biomarker in COPD in means of reflecting severity of disease and prognosis of patients.