Association between Elevated C-Reactive Protein Levels and Mortality in Patients with Pericarditis: A Retrospective Study of 160 Patients
Published: 2023-06-23
Page: 246-251
Issue: 2023 - Volume 6 [Issue 1]
Karim Mounaouir *
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Mohammed Nachid
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Ali El Jazouli
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Ismail Benhar
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Meryem Haboub
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Bennouna Ghali
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Arous Salim
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Abdenasser Drighil
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
Rachida Habbal
Cardiology Division , Ibn Rochd University Hospital, Casablanca 20250, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Pericarditis is an inflammatory condition of the pericardium that can cause significant morbidity and mortality. The aim of this study was to investigate the association between C-reactive protein (CRP) levels and mortality in patients with pericarditis.
Methods: We conducted a retrospective study of 160 patients with pericarditis who were admitted to a tertiary care hospital: Chu Ibn Rochd of Casablanca, between January 2015 and December 2019. Data on demographics, comorbidities, laboratory parameters, and outcomes were collected. The primary outcome was all-cause mortality.
Results: The median age of the patients was 58 years, and 56% were male. The most common comorbidities were hypertension (55%) and diabetes (21%). The median CRP level on admission was 44 mg/L. During a median follow-up of 24 months, 12 patients (7.5%) died. Elevated CRP levels on admission were associated with an increased risk of mortality (adjusted hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.02-1.20, p = 0.009). Older age (adjusted HR 1.07; 95% CI 1.02-1.13; p = 0.007) and diabetes (adjusted HR 2.33; 95% CI 1.07-5.08; p = 0.033) were also associated with increased mortality.
Conclusions: Elevated CRP levels on admission were associated with an increased risk of mortality in patients with pericarditis. Measuring CRP levels may be useful in identifying patients who are at high risk of mortality and who may require more aggressive management. Further studies are needed to confirm our findings and to investigate the role of CRP levels in the management of pericarditis.
Keywords: Pericarditis, C-reactive protein, mortality, biomarkers, retrospective study, comorbidities, prognosis
How to Cite
References
Imazio M, Brucato A, Adler Y, et al. Diagnosis and management of pericardial diseases: executive summary of the position paper from the ESC Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2015;36(38):2921-2964.
Ciliberto GR, Patti G, Violi F. Inflammation, oxidative stress, and atherothrombosis in acute coronary syndromes: moving beyond academic definitions. Eur Heart J Suppl. 2019;21(Suppl D):D2-D11.
Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107(3):363-369.
Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation. 2001; 103(13):1813-1818.
Lagrand WK, Niessen HW, Wolbink GJ, Jaspars LH, Visser CA, Verheugt FW, Meijer CJ, Hack CE. C-reactive protein colocalizes with complement in human hearts during acute myocardial infarction. Circulation. 1997;95(1):97-103.
Buckley DI, Fu R, Freeman M, Rogers K, Helfand M. C-reactive protein as a risk factor for coronary heart disease: a systematic review and meta-analyses for the US Preventive Services Task Force. Ann Intern Med. 2009;151(7):483-495.
Wu N, Xu B, Xiang Y, Wu L, Tang X, Huang Y, Xiang X, Liu H, Zhou Q. Association between C-reactive protein and atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis. Europace. 2019;21(2):279-289.
Ridker PM. C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol. 2007; 49(21):2129-2138.
Kaye DM, Woodward M, Rothwell PM, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375(9709):132-140.
Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The task force for the diagnosis and management of pericardial diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921-2964.
Imazio M, Brucato A, Markel G, et al. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2013;369(16): 1522-1528.
Imazio M, Brucato A, Maestroni S, et al. Risk stratification in recurrent idiopathic pericarditis: the role of clinical and serological markers. Intern Emerg Med. 2012;7(3):243-250.
Brucato A, Imazio M, Maestroni S, et al. Risk of constrictive pericarditis after acute pericarditis. Circulation. 2017;136(14): 123-132.
LeWinter MM. Acute pericarditis. N Engl J Med. 2014;371(25):2410-2416.