Vitamin C Deficiency, High-Sensitivity C-Reactive Protein, and Cardiac Event-Free Survival in Patients with Heart Failure

Eun Kyeung Song, seokmin kang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Vitamin C is related to lower levels of high-sensitivity C-reactive protein (hsCRP), an inflammatory biomarker that predicts cardiovascular disease. Whether vitamin C deficiency is associated with hsCRP and cardiac events in heart failure (HF) patients has not been examined. Purpose: The aim of this study is to determine the relationships among vitamin C intake, serum levels of hsCRP, and cardiac events. Methods: A total of 200 HF patients completed a 3-day food diary to determine vitamin C deficiency and provided blood to measure serum levels of hsCRP. Patients were followed for 2 years to obtain data on cardiac event-free survival. Moderation analyses with hierarchical logistic and Cox regressions were used for the data analysis. Results: Seventy-eight patients (39%) had vitamin C deficiency and 100 (50%) had an hsCRP level higher than 3 mg/L. Vitamin C deficiency was associated with an hsCRP level higher than 3 mg/L in the hierarchical logistic regression (odds ratio, 2.40; 95% confidence interval, [1.13-5.10]; P =.023). Vitamin C deficiency (hazard ratio, 1.68; 95% CI, 1.05-2.69, P =.029) and hsCRP level higher than 3 mg/L (hazard ratio, 1.79; 95% CI, 1.07-3.01; P =.027) predicted shorter cardiac event-free survival in hierarchical Cox regression. The interaction of hsCRP level higher than 3 mg/L and vitamin C deficiency produced a 2.3-fold higher risk for cardiac events (P =.002) in moderation analysis. Higher level of hsCRP predicted shorter cardiac event-free survival only in patients with vitamin C deficiency (P =.027), but not in those with vitamin C adequacy. Conclusion: Vitamin C deficiency moderated the relationship between inflammation and cardiac events in patients with HF. Future study is required to determine whether adequate intake of vitamin C could play a protective role against the impact of inflammation on cardiac events in HF patients.

Original languageEnglish
Pages (from-to)6-12
Number of pages7
JournalJournal of Cardiovascular Nursing
Volume33
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Ascorbic Acid Deficiency
C-Reactive Protein
Disease-Free Survival
Heart Failure
Ascorbic Acid
Logistic Models
Inflammation
Diet Records
Serum
Cardiovascular Diseases
Biomarkers
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

@article{54e24ae90adc47d497ccee82d54ad0cd,
title = "Vitamin C Deficiency, High-Sensitivity C-Reactive Protein, and Cardiac Event-Free Survival in Patients with Heart Failure",
abstract = "Background: Vitamin C is related to lower levels of high-sensitivity C-reactive protein (hsCRP), an inflammatory biomarker that predicts cardiovascular disease. Whether vitamin C deficiency is associated with hsCRP and cardiac events in heart failure (HF) patients has not been examined. Purpose: The aim of this study is to determine the relationships among vitamin C intake, serum levels of hsCRP, and cardiac events. Methods: A total of 200 HF patients completed a 3-day food diary to determine vitamin C deficiency and provided blood to measure serum levels of hsCRP. Patients were followed for 2 years to obtain data on cardiac event-free survival. Moderation analyses with hierarchical logistic and Cox regressions were used for the data analysis. Results: Seventy-eight patients (39{\%}) had vitamin C deficiency and 100 (50{\%}) had an hsCRP level higher than 3 mg/L. Vitamin C deficiency was associated with an hsCRP level higher than 3 mg/L in the hierarchical logistic regression (odds ratio, 2.40; 95{\%} confidence interval, [1.13-5.10]; P =.023). Vitamin C deficiency (hazard ratio, 1.68; 95{\%} CI, 1.05-2.69, P =.029) and hsCRP level higher than 3 mg/L (hazard ratio, 1.79; 95{\%} CI, 1.07-3.01; P =.027) predicted shorter cardiac event-free survival in hierarchical Cox regression. The interaction of hsCRP level higher than 3 mg/L and vitamin C deficiency produced a 2.3-fold higher risk for cardiac events (P =.002) in moderation analysis. Higher level of hsCRP predicted shorter cardiac event-free survival only in patients with vitamin C deficiency (P =.027), but not in those with vitamin C adequacy. Conclusion: Vitamin C deficiency moderated the relationship between inflammation and cardiac events in patients with HF. Future study is required to determine whether adequate intake of vitamin C could play a protective role against the impact of inflammation on cardiac events in HF patients.",
author = "Song, {Eun Kyeung} and seokmin kang",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/JCN.0000000000000389",
language = "English",
volume = "33",
pages = "6--12",
journal = "Journal of Cardiovascular Nursing",
issn = "0889-4655",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Vitamin C Deficiency, High-Sensitivity C-Reactive Protein, and Cardiac Event-Free Survival in Patients with Heart Failure. / Song, Eun Kyeung; kang, seokmin.

In: Journal of Cardiovascular Nursing, Vol. 33, No. 1, 01.01.2018, p. 6-12.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Vitamin C Deficiency, High-Sensitivity C-Reactive Protein, and Cardiac Event-Free Survival in Patients with Heart Failure

AU - Song, Eun Kyeung

AU - kang, seokmin

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Vitamin C is related to lower levels of high-sensitivity C-reactive protein (hsCRP), an inflammatory biomarker that predicts cardiovascular disease. Whether vitamin C deficiency is associated with hsCRP and cardiac events in heart failure (HF) patients has not been examined. Purpose: The aim of this study is to determine the relationships among vitamin C intake, serum levels of hsCRP, and cardiac events. Methods: A total of 200 HF patients completed a 3-day food diary to determine vitamin C deficiency and provided blood to measure serum levels of hsCRP. Patients were followed for 2 years to obtain data on cardiac event-free survival. Moderation analyses with hierarchical logistic and Cox regressions were used for the data analysis. Results: Seventy-eight patients (39%) had vitamin C deficiency and 100 (50%) had an hsCRP level higher than 3 mg/L. Vitamin C deficiency was associated with an hsCRP level higher than 3 mg/L in the hierarchical logistic regression (odds ratio, 2.40; 95% confidence interval, [1.13-5.10]; P =.023). Vitamin C deficiency (hazard ratio, 1.68; 95% CI, 1.05-2.69, P =.029) and hsCRP level higher than 3 mg/L (hazard ratio, 1.79; 95% CI, 1.07-3.01; P =.027) predicted shorter cardiac event-free survival in hierarchical Cox regression. The interaction of hsCRP level higher than 3 mg/L and vitamin C deficiency produced a 2.3-fold higher risk for cardiac events (P =.002) in moderation analysis. Higher level of hsCRP predicted shorter cardiac event-free survival only in patients with vitamin C deficiency (P =.027), but not in those with vitamin C adequacy. Conclusion: Vitamin C deficiency moderated the relationship between inflammation and cardiac events in patients with HF. Future study is required to determine whether adequate intake of vitamin C could play a protective role against the impact of inflammation on cardiac events in HF patients.

AB - Background: Vitamin C is related to lower levels of high-sensitivity C-reactive protein (hsCRP), an inflammatory biomarker that predicts cardiovascular disease. Whether vitamin C deficiency is associated with hsCRP and cardiac events in heart failure (HF) patients has not been examined. Purpose: The aim of this study is to determine the relationships among vitamin C intake, serum levels of hsCRP, and cardiac events. Methods: A total of 200 HF patients completed a 3-day food diary to determine vitamin C deficiency and provided blood to measure serum levels of hsCRP. Patients were followed for 2 years to obtain data on cardiac event-free survival. Moderation analyses with hierarchical logistic and Cox regressions were used for the data analysis. Results: Seventy-eight patients (39%) had vitamin C deficiency and 100 (50%) had an hsCRP level higher than 3 mg/L. Vitamin C deficiency was associated with an hsCRP level higher than 3 mg/L in the hierarchical logistic regression (odds ratio, 2.40; 95% confidence interval, [1.13-5.10]; P =.023). Vitamin C deficiency (hazard ratio, 1.68; 95% CI, 1.05-2.69, P =.029) and hsCRP level higher than 3 mg/L (hazard ratio, 1.79; 95% CI, 1.07-3.01; P =.027) predicted shorter cardiac event-free survival in hierarchical Cox regression. The interaction of hsCRP level higher than 3 mg/L and vitamin C deficiency produced a 2.3-fold higher risk for cardiac events (P =.002) in moderation analysis. Higher level of hsCRP predicted shorter cardiac event-free survival only in patients with vitamin C deficiency (P =.027), but not in those with vitamin C adequacy. Conclusion: Vitamin C deficiency moderated the relationship between inflammation and cardiac events in patients with HF. Future study is required to determine whether adequate intake of vitamin C could play a protective role against the impact of inflammation on cardiac events in HF patients.

UR - http://www.scopus.com/inward/record.url?scp=85038589062&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038589062&partnerID=8YFLogxK

U2 - 10.1097/JCN.0000000000000389

DO - 10.1097/JCN.0000000000000389

M3 - Article

VL - 33

SP - 6

EP - 12

JO - Journal of Cardiovascular Nursing

JF - Journal of Cardiovascular Nursing

SN - 0889-4655

IS - 1

ER -