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Article Dans Une Revue International Journal of Cardiology Année : 2024

High-sensitivity C-reactive protein in heart failure with preserved ejection fraction: Findings from TOPCAT

Résumé


Background: Inflammation plays a central role in the genesis and progression of heart failure with preserved ejection fraction (HFpEF). C-reactive protein (CRP) is widely used as means to assess systemic inflammation, and elevated levels of CRP have been associated with poor HF prognosis. Identification of chronic low-grade inflammation in outpatients can be performed measuring high-sensitivity CRP (hsCRP). The clinical characteristics and outcome associations of a pro-inflammatory state among outpatients with HFpEF requires further study.

Aims: Using a biomarker subset of TOPCAT-Americas (NCT00094302), we aim to characterize HFpEF patients according to hsCRP levels and study the prognostic associations of hsCRP.

Methods: hsCRP was available in a subset of 232 participants. Comparisons were performed between patients with hsCRP <2 mg/L and ≥ 2 mg/L. Cox regression models were used to study the association between hsCRP and the study outcomes.

Results: Compared to patients with hsCRP <2 mg/L (n = 89, 38%), those with hsCRP ≥2 mg/L (n = 143, 62%) had more frequent HF hospitalizations prior to randomization, chronic obstructive pulmonary disease, orthopnea, higher body mass index, and worse health-related quality-of-life. A hsCRP level ≥ 2 mg/L was associated with an increased risk of cardiovascular death and HF hospitalizations: hsCRP ≥2 mg/L vs <2 mg/L adjusted HR 2.36, 95%CI 1.27-4.38, P = 0.006. Spironolactone did not influence hsCRP levels from baseline to month 12: gMean ratio = 1.11, 95%CI 0.87-1.42, P = 0.39.

Conclusions: A hsCRP ≥2 mg/L identified HFpEF patients with a high risk of HF events and cardiovascular mortality. Spironolactone did not influence hsCRP levels at 12 months.
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Dates et versions

hal-04475086 , version 1 (23-02-2024)

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Paternité - Pas d'utilisation commerciale - Pas de modification

Identifiants

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João Pedro Ferreira, Brian L Claggett, Jiankang Liu, Abhinav Sharma, Akshay S Desai, et al.. High-sensitivity C-reactive protein in heart failure with preserved ejection fraction: Findings from TOPCAT. International Journal of Cardiology, 2024, pp.131818. ⟨10.1016/j.ijcard.2024.131818⟩. ⟨hal-04475086⟩
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