Prognostic Value of C-reactive Protein in Patients with Non-ischemic Dilated Cardiomyopathy: Prospective Study

ABSTRACT

BACKGROUND AND OBJECTIVES: Previous studies advocated the C-reactive protein (CRP) as an objective marker of the inflammatory reaction in cardiovascular disease, and an independent risk factor for predicting the progression of heart failure (HF) of an ischemic origin. However, it is unclear if this can also be applied to non-ischemic HF. We report the measurement of the CRP in non-ischemic dilated cardiomyopathy (DCM), and its relationship to the prognosis. SUBJECTS AND METHODS: Sixty-nine consecutive patients, with non-ischemic DCM, were enrolled based on their history, echocardiography and coronary angiography findings. The variables, including NYHA functional class, were examined. The CRP levels were measured with high sensitive turbidometry; and each patient followed up for 18 months. The endpoints of the study were considered as readmission and death. RESULTS: Out of the 69 patients, there were 47 (68%) were males and 22 (32%) females, with an average age of 60+/-12. The CRP level (mg/d) in the patients with DCM (1.66+/-2.91) was higher than in the controls (0.07+/-0.25;p<0.001), and increased in relation to the NYHA functional class on discharge (I0.98+/-2.15, II0.78+/-1.48, III3.55+/-4.66, IV2.94+/-2.39;p<0.01). During the follow-up, 19(28%) experienced the aggravation of HF and had higher CRP and NYHA functional classes, and lower Na+, K+ and hemoglobin levels. From a multiple regression analysis, only the K+ and NYHA functional class on discharge revealed significant relationships with the aggravation of HF (p<0.05). Moreover, an increased in the CRP level had a significant negative relation to the Na+ only (p<0.05). CONCLUSION: The patients with non-ischemic DCM exhibited an increase in CRP levels in relation to the severity of the HF. However, the levels of CRP in non-ischemic DCM could not elucidate the prognosis as with ischemic HF.