Clinical InvestigationCongestive Heart DiseaseRelationship of high-sensitivity C-reactive protein to prognosis and other prognostic markers in outpatients with heart failure
Section snippets
Methods
All patients referred to the heart failure clinic for the investigation of the presence and/or cause of heart failure had hsCRP routinely measured. Patients were referred directly to the clinic by physicians working in the community or from our hospital colleagues. All signed a standard informed consent form that was approved by our local ethics committee.
The principal population of interest was patients with a diagnosis of heart failure secondary to LVSD who were free of infection, other
Results
Of 1941 patients referred to our clinic with a diagnosis of possible heart failure between September 11, 2001, and February 25, 2005, for whom hsCRP was available, the diagnosis of heart failure due to LVSD was made in 1178 patients. Heart failure was considered secondary to valve disease in 40 patients, but heart failure in the absence of LVSD or valve disease was diagnosed in only 77 patients, perhaps because the clinic policy discouraged such a diagnosis without definitive evidence of
Discussion
This study demonstrates that in patients with LVSD, an increased hsCRP is associated with poorer functional capacity and an adverse outcome independent of other prognostic markers. It also describes changes in hsCRP over the following year and their relationship to other measures of disease progression. These data suggest that hsCRP, a simple and widely available test, might be useful in clinical practice either to identify patients with an adverse outcome or, potentially, as a new target for
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