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Association between C-reactive protein levels at hospital admission and long-term mortality in patients with acute decompensated heart failure

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Abstract

The C-reactive protein (CRP) levels obtained at hospital admission are associated with the prognosis of several cardiovascular diseases, including acute coronary syndrome. Although the admission CRP level is associated with in-hospital mortality in patients with acute decompensated heart failure (ADHF), there are limited data on the association between the admission CRP level and long-term mortality in patients with ADHF. This study included consecutive ADHF patients admitted to our institution from 2007 to 2011. Eligible patients were divided into four groups based on quartiles of admission CRP levels. The association between the admission CRP level and long-term mortality was assessed by multivariable Cox proportional analysis, including other independent variables with p values < 0.1 in the univariable analyses. Overall, 527 eligible patients were examined. There were 142 deaths (27%) during a median follow-up period of 2.0 years. In the multivariable analysis, the hazard ratio (HR) significantly increased with admission CRP levels in a dose-dependent manner for mortality (p for trend = 0.034). Multivariable analysis also showed a significant association between the admission CRP level, when treated as a natural logarithm-transformed continuous variable, and increased mortality (HR 1.16, p = 0.030). In patients with ADHF, the admission CRP level was associated with an increased risk of long-term mortality.

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Funding

A grant was awarded to The Intractable Respiratory Diseases and Pulmonary Hypertension Research Group, from the Ministry of Health, Labor and Welfare, Grant/Award Number: H29-027; Health, Labour and Welfare Sciences Research Grants, Research on Region Medical, Grant/Award Number: H30-iryou-ippan-009; MEXT-Supported Program for the Strategic Research Foundation at Private Universities, 2014–2018 (Ministry of Education, Culture, Sports, Science and Technology); JSPS KAKENHI, Grant/Award Number: JP17K09527.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Hiroki Matsumoto, Takatoshi Kasai, Akihiro Sato, Sayaki Ishiwata, Shoichiro Yatsu, Jun Shitara, Azusa Murata, Takao Kato, Shoko Suda, Yuya Matsue, Masaru Hiki, Atsutoshi Takagi & Hiroyuki Daida

  2. Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Hiroki Matsumoto, Takatoshi Kasai, Akihiro Sato, Sayaki Ishiwata & Yuya Matsue

  3. Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan

    Takatoshi Kasai

  4. Department of Cardiology, Koshigaya Municipal Hospital, Saitama, Japan

    Atsutoshi Takagi

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  1. Hiroki Matsumoto
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  2. Takatoshi Kasai
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Correspondence to Takatoshi Kasai.

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Conflict of interest

Drs. Hiroki Matsumoto, Takatoshi Kasai, Akihiro Sato, Sayaki Ishiwata, and Yuya Matsue are affiliated with a department endowed by Philips Respironics, ResMed, and Fukuda Denshi. Dr. Hiroyuki Daida received research grants from various pharmaceutical companies and payment for lectures, including service in speakers’ bureaus from Medtronic Japan, AstraZeneca K.K., MSD K.K., Ono Pharmaceutical Co. Ltd, GlaxoSmithKline K.K., Shionogi & Co. Ltd, Daiichi Sankyo Company, Takeda Pharmaceutical Co. Ltd, Nippon Boehringer Ingelheim Co. Ltd, Bayer Yakuhin, Ltd, Terumo Corporation, and Astellas Pharma Inc. The other authors report no conflicts of interest.

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Matsumoto, H., Kasai, T., Sato, A. et al. Association between C-reactive protein levels at hospital admission and long-term mortality in patients with acute decompensated heart failure. Heart Vessels 34, 1961–1968 (2019). https://doi.org/10.1007/s00380-019-01435-9

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