Soufian T AlMahameed1, Gian M Novaro2, Craig R Asher2, Penny L Hougthaling3, Rodrigo M Lago2, Deepak L Bhatt4, Amjad T AlMahameed5, Eric J Topol6. 1. Carilion Clinic and Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, Virginia, USA. 2. Department of Cardiology, Cleveland Clinic Florida, Weston, Florida, USA. 3. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA. 4. VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA. 5. Interventional Cardiology and Vascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 6. The Scripps Research Institute and Scripps Clinic, La Jolla, California, USA.
Abstract
OBJECTIVE: The purpose of this study was to determine whether high-sensitivity C-reactive protein (hsCRP) levels differ among patients with acute aortic syndromes (AAS) and if hsCRP could predict their long-term outcomes. DESIGN: Retrospective observational study. SETTING: Cleveland Clinic Hospital, Cleveland, Ohio. PATIENTS: 115 consecutive patients with AAS admitted to the cardiac intensive care unit. INTERVENTIONS: HsCRP and other laboratory data were measured within 24 h of admission. Demographic, imaging and laboratory data were obtained at the time of presentation. For the long-term survival analysis, the social security death index was used to determine all-cause mortality. MAIN OUTCOME MEASURES: HsCRP levels among AAS patients. RESULTS: Hospital mortality was 4.3% for AAS patients. HsCRP levels differed significantly among AAS; the median hsCRP was higher in the aortic dissection group (49 mg/l) than in those with penetrating aortic ulcer (28 mg/l), symptomatic aortic aneurysm (14 mg/l), and intramural haematoma (10 mg/l); (p=0.02). In multivariable analysis, aortic dissection patients had higher hsCRP levels than intramural haematoma (p=0.03) and symptomatic aortic aneurysm (p=0.04) patients, after adjusting for age and gender. Multivariable Cox regression analyses showed that elevated hsCRP levels at presentation were associated with a higher long-term mortality (p=0.007). CONCLUSIONS: Among patients with AAS, those with aortic dissection have the highest hsCRP levels at presentation. Elevated hsCRP independently predicted a higher long-term mortality in AAS patients.
OBJECTIVE: The purpose of this study was to determine whether high-sensitivity C-reactive protein (hsCRP) levels differ among patients with acute aortic syndromes (AAS) and if hsCRP could predict their long-term outcomes. DESIGN: Retrospective observational study. SETTING: Cleveland Clinic Hospital, Cleveland, Ohio. PATIENTS: 115 consecutive patients with AAS admitted to the cardiac intensive care unit. INTERVENTIONS: HsCRP and other laboratory data were measured within 24 h of admission. Demographic, imaging and laboratory data were obtained at the time of presentation. For the long-term survival analysis, the social security death index was used to determine all-cause mortality. MAIN OUTCOME MEASURES: HsCRP levels among AASpatients. RESULTS: Hospital mortality was 4.3% for AASpatients. HsCRP levels differed significantly among AAS; the median hsCRP was higher in the aortic dissection group (49 mg/l) than in those with penetrating aortic ulcer (28 mg/l), symptomatic aortic aneurysm (14 mg/l), and intramural haematoma (10 mg/l); (p=0.02). In multivariable analysis, aortic dissection patients had higher hsCRP levels than intramural haematoma (p=0.03) and symptomatic aortic aneurysm (p=0.04) patients, after adjusting for age and gender. Multivariable Cox regression analyses showed that elevated hsCRP levels at presentation were associated with a higher long-term mortality (p=0.007). CONCLUSIONS: Among patients with AAS, those with aortic dissection have the highest hsCRP levels at presentation. Elevated hsCRP independently predicted a higher long-term mortality in AASpatients.
Authors: J Juvonen; H M Surcel; J Satta; A M Teppo; A Bloigu; H Syrjälä; J Airaksinen; M Leinonen; P Saikku; T Juvonen Journal: Arterioscler Thromb Vasc Biol Date: 1997-11 Impact factor: 8.311
Authors: Tryfon Vainas; Tim Lubbers; Frank R M Stassen; Selma B Herngreen; Marja P van Dieijen-Visser; Cathrien A Bruggeman; Peter J E H M Kitslaar; Geert Willem H Schurink Journal: Circulation Date: 2003-03-04 Impact factor: 29.690
Authors: Yoram Agmon; Bijoy K Khandheria; Irene Meissner; Tanya M Petterson; W Michael O'Fallon; David O Wiebers; Teresa J H Christianson; Joseph P McConnell; Jack P Whisnant; James B Seward; A Jamil Tajik Journal: Arch Intern Med Date: 2004-09-13