Background: Systemic inflammation has long been recognized as a precipitator of acute congestive heart failure(CHF). The impact of inflammation on prognosis in acute CHF, however, is unknown. Methods: This study evalu...Background: Systemic inflammation has long been recognized as a precipitator of acute congestive heart failure(CHF). The impact of inflammation on prognosis in acute CHF, however, is unknown. Methods: This study evaluated the prognostic role of inflammation among 214 consecutive patients presenting with acute CHF to the emergency department. Patients were stratified according to C-reactive protein(CRP) levels determined on admission. The primary end point was all-cause mortality during 24-month follow-up. Results: The median CRP level was 13.0 mg/L, with an intertertile range of 6.0 to 25.0 mg/L. Initial and long-term outcomes were significantly different to the detriment of patients with higher CRP levels. Patients in the highest CRP tertile significantly more often required admission to the intensive care unit(33%vs 14%in patients in the first tertile, P=.028) and died inhospital(15%vs 2%in patients in the first tertile, P=.027). Cumulative 24-month mortality rates were 33.5%in the first, 42.4%in the second, and 53.6%in the third tertile(P=.0265 by log-rank test). After multivariate adjustment, CRP remained an independent predictor of death(hazard ratio 1.4, 95%CI 1.1-1.8 for each step up in tertile, P=.044). Conclusions: Inflammation is a significant and independent predictor of long-term mortality in patients with acute CHF.展开更多
文摘Background: Systemic inflammation has long been recognized as a precipitator of acute congestive heart failure(CHF). The impact of inflammation on prognosis in acute CHF, however, is unknown. Methods: This study evaluated the prognostic role of inflammation among 214 consecutive patients presenting with acute CHF to the emergency department. Patients were stratified according to C-reactive protein(CRP) levels determined on admission. The primary end point was all-cause mortality during 24-month follow-up. Results: The median CRP level was 13.0 mg/L, with an intertertile range of 6.0 to 25.0 mg/L. Initial and long-term outcomes were significantly different to the detriment of patients with higher CRP levels. Patients in the highest CRP tertile significantly more often required admission to the intensive care unit(33%vs 14%in patients in the first tertile, P=.028) and died inhospital(15%vs 2%in patients in the first tertile, P=.027). Cumulative 24-month mortality rates were 33.5%in the first, 42.4%in the second, and 53.6%in the third tertile(P=.0265 by log-rank test). After multivariate adjustment, CRP remained an independent predictor of death(hazard ratio 1.4, 95%CI 1.1-1.8 for each step up in tertile, P=.044). Conclusions: Inflammation is a significant and independent predictor of long-term mortality in patients with acute CHF.
