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Is there a C-reactive protein value beyond which one should consider infection as the cause of acute heart failure?

2018Journal article Open access
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dc.contributor.authorPereira, Joana
dc.contributor.authorRibeiro, Ana
dc.contributor.authorFerreira-Coimbra, Joao
dc.contributor.authorBarroso, Isaac
dc.contributor.authorGuimaraes, Joao-Tiago
dc.contributor.authorBettencourt, Paulo
dc.contributor.authorLourenco, Patricia
dc.date.accessioned2018-11-29T01:28:29Z
dc.date.available2018-11-29T01:28:29Z
dc.date.issued2018
dc.description.abstractBACKGROUND: Heart Failure (HF) is a low grade inflammatory condition. High sensitivity C-reactive protein (hsCRP) is an established marker of inflammation. A cut-off value of hsCRP beyond which an infection should be sought has never been studied in HF. We aimed to determine the best hsCRP cut-off for infection prediction in acute HF. METHODS: We analyzed patients included in an acute HF registry - EDIFICA (Estratificação de Doentes com InsuFIciência Cardíaca Aguda). Admission hsCRP measurement was available as part of the registry's protocol. Patients with acute coronary syndrome as the cause of acute HF were excluded from the registry. Infection was considered according to the diagnosis registered in the discharge record. A receiver-operating characteristic (ROC) curve was used to determine the best hsCRP cut-off for infection prediction. RESULTS: We studied 615 patients. Mean age was 76 years, 45.2% were male, 60.3% had systolic dysfunction. Median admission hsCRP was 20.3 (9.5-55.5)mg/L; in 41.6% the cause of decompensation was an infection. The area under the ROC curve for admission hsCRP in the prediction of infection was 0.79 (0.76-0.83); the best hsCRP cut-off was 25 mg/L with a sensitivity of 72.7%, specificity 77.2%, positive predictive value 69.4% and negative predictive value 79.9%. Age and elevated hsCRP independently associated with an infection as the precipitant of acute HF. CONCLUSIONS: We suggest 25 mg/L as a cut-off beyond which an infection should be sought underlying acute HF. Almost 80% of the patients with hsCRP< 25 mg/L are not infected and 69.4% of those with higher hsCRP have a concomitant infection.pt_PT
dc.description.sponsorshipNorte Portugal Regional Operational Programme
dc.description.sponsorshipDevelopment Fund (ERDF)
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBMC Cardiovasc Disord. 2018 Feb 27;18(1)pt_PT
dc.identifier.doi10.1186/s12872-018-0778-4pt_PT
dc.identifier.issn1471-2261
dc.identifier.urihttp://hdl.handle.net/10400.26/25065
dc.language.isoengpt_PT
dc.publisherBMCpt_PT
dc.subjectAcute heart failurept_PT
dc.subjectC-reactive proteinpt_PT
dc.subjectCut-offpt_PT
dc.subjectInfectionpt_PT
dc.titleIs there a C-reactive protein value beyond which one should consider infection as the cause of acute heart failure?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.volume18pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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