Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry)

Jin Joo Park, Dong Ju Choi, Chang Hwan Yoon, Il Young Oh, Eun Seok Jeon, Jae Joong Kim, Myeong Chan Cho, Shung Chull Chae, Kyu Hyung Ryu, Byung Su Yoo, Seok Min Kang, Byung Hee Oh

Research output: Contribution to journalArticle

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Abstract

The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3%) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4%, Q2 9.5%, Q3 16.9%, Q4 19.3%, p <0.001) and NT-proBNP quartiles (Q1 7.0%, Q2 13.4%, Q3 11.6%, Q4 20.4%, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95% confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95% CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95% CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF.

Original languageEnglish
Pages (from-to)511-517
Number of pages7
JournalAmerican Journal of Cardiology
Volume113
Issue number3
DOIs
Publication statusPublished - 2014 Feb 1

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Natriuretic Peptides
C-Reactive Protein
Registries
Heart Failure
Confidence Intervals
Mortality
Korea
Cohort Studies
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Jin Joo ; Choi, Dong Ju ; Yoon, Chang Hwan ; Oh, Il Young ; Jeon, Eun Seok ; Kim, Jae Joong ; Cho, Myeong Chan ; Chae, Shung Chull ; Ryu, Kyu Hyung ; Yoo, Byung Su ; Kang, Seok Min ; Oh, Byung Hee. / Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry). In: American Journal of Cardiology. 2014 ; Vol. 113, No. 3. pp. 511-517.
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abstract = "The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3{\%}) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4{\%}, Q2 9.5{\%}, Q3 16.9{\%}, Q4 19.3{\%}, p <0.001) and NT-proBNP quartiles (Q1 7.0{\%}, Q2 13.4{\%}, Q3 11.6{\%}, Q4 20.4{\%}, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95{\%} confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95{\%} CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95{\%} CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF.",
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Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry). / Park, Jin Joo; Choi, Dong Ju; Yoon, Chang Hwan; Oh, Il Young; Jeon, Eun Seok; Kim, Jae Joong; Cho, Myeong Chan; Chae, Shung Chull; Ryu, Kyu Hyung; Yoo, Byung Su; Kang, Seok Min; Oh, Byung Hee.

In: American Journal of Cardiology, Vol. 113, No. 3, 01.02.2014, p. 511-517.

Research output: Contribution to journalArticle

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T1 - Prognostic value of C-reactive protein as an inflammatory and n-terminal probrain natriuretic peptide as a neurohumoral marker in acute heart failure (from the Korean heart failure registry)

AU - Park, Jin Joo

AU - Choi, Dong Ju

AU - Yoon, Chang Hwan

AU - Oh, Il Young

AU - Jeon, Eun Seok

AU - Kim, Jae Joong

AU - Cho, Myeong Chan

AU - Chae, Shung Chull

AU - Ryu, Kyu Hyung

AU - Yoo, Byung Su

AU - Kang, Seok Min

AU - Oh, Byung Hee

PY - 2014/2/1

Y1 - 2014/2/1

N2 - The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3%) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4%, Q2 9.5%, Q3 16.9%, Q4 19.3%, p <0.001) and NT-proBNP quartiles (Q1 7.0%, Q2 13.4%, Q3 11.6%, Q4 20.4%, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95% confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95% CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95% CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF.

AB - The neurohumoral and inflammatory pathways are regarded as the main mechanisms for the progression of heart failure. We sought to investigate the prognostic value of high-sensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) by evaluating their relation with 12-month mortality rate in this prospective cohort study from 24 academic hospitals in Korea. In 1,608 patients with acute heart failure (AHF), the median hs-CRP and NT-proBNP values were 0.77 mg/dl (interquartile range 0.29 to 2.84) and 4,638 pg/ml (interquartile range 1,945 to 10,852), respectively. During the 12-month follow-up, 213 patients (13.3%) died. The mortality rate increased from the lowest to the highest hs-CRP quartiles (Q1 7.4%, Q2 9.5%, Q3 16.9%, Q4 19.3%, p <0.001) and NT-proBNP quartiles (Q1 7.0%, Q2 13.4%, Q3 11.6%, Q4 20.4%, p <0.001). After adjustment, both hs-CRP (hazard ratio [HR] 1.811, 95% confidence interval [CI] 1.138 to 2.882) and NT-proBNP (HR 1.971, 95% CI 1.219 to 3.187) were independent predictors of 12-month mortality among others. When combining both hs-CRP and NT-proBNP and stratifying the patients according to their median values, patients with elevation of both hs-CRP and NT-proBNP values had 2.4-fold increased hazards (HR 2.382, 95% CI 1.509 to 3.761) compared with those without elevation of both markers. In Korean patients with AHF, patients with increased levels of both hs-CRP and NT-proBNP had worse clinical outcomes. The combination of the neurohumoral and inflammatory markers may provide a better strategy for risk stratification of Asian patients with AHF.

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