Concentrations of C-Reactive Protein and B-Type Natriuretic Peptide 30 Days after Acute Coronary Syndromes Independently Predict Hospitalization for Heart Failure and Cardiovascular Death Export

@article{citeulike:3974602, abstract = {Background: Heart failure (HF) is an important cause of morbidity in patients with acute coronary syndromes (ACS). C-reactive protein (CRP) has been implicated in experimental models as exacerbating myocardial injury, but data regarding the clinical relationship of high-sensitivity CRP (hsCRP) and B-type natriuretic peptide (BNP) concentrations with the risk of HF after ACS are few. Methods: PROVE IT-TIMI 22 randomized 4162 patients who had been stabilized after ACS to either intensive or moderate statin therapy. hsCRP and BNP were measured 30 days after randomization. Hospitalizations for HF and cardiovascular death occurring after day 30 were assessed for a mean follow-up of 24 months. Results: Patients who developed HF had higher concentrations of hsCRP (3.7 mg/L vs 1.9 mg/L, P < 0.001) and BNP (59 ng/L vs 22 ng/L, P < 0.0001). HF increased in a stepwise manner with hsCRP quartile [adjusted hazard ratio (HRadj) for Q4 vs Q1, 2.5; P = 0.01] and BNP quartile (HRadj for Q4 vs Q1, 5.8; P < 0.001), with similar results obtained for HF and cardiovascular death. In a multivariable analysis, higher concentrations of hsCRP and BNP were both independently associated with HF [HRadj, 1.9 for hsCRP >2.0 mg/L (P = 0.01) and 4.2 for BNP >80 ng/L (P < 0.001)]. Patients with increases in both markers were at the greatest risk of HF, compared with patients without an increased marker concentration (HRadj, 8.3; P = 0.01). The benefit of intensive statin therapy in reducing HF was consistent among all patients, regardless of hsCRP or BNP concentration. Conclusions: Both hsCRP and BNP measured 30 days after ACS are independently associated with the risk of HF and cardiovascular death, with the greatest risk occurring when both markers are increased. 10.1373/clinchem.2008.117192}, author = {Scirica, Benjamin M. and Cannon, Christopher P. and Sabatine, Marc S. and Jarolim, Petr and Sloane, Sarah and Rifai, Nader and Braunwald, Eugene and Morrow, David A. and For}, citeulike-article-id = {3974602}, citeulike-linkout-0 = {http://dx.doi.org/10.1373/clinchem.2008.117192}, citeulike-linkout-1 = {http://www.clinchem.org/cgi/content/abstract/55/2/265}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/19074516}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=19074516}, day = {1}, doi = {10.1373/clinchem.2008.117192}, journal = {Clin Chem}, keywords = {c-reactive-protein, cardiovascular-disease, heart-failure}, month = {February}, number = {2}, pages = {265--273}, posted-at = {2009-01-28 23:22:36}, priority = {2}, title = {Concentrations of C-Reactive Protein and B-Type Natriuretic Peptide 30 Days after Acute Coronary Syndromes Independently Predict Hospitalization for Heart Failure and Cardiovascular Death}, url = {http://dx.doi.org/10.1373/clinchem.2008.117192}, volume = {55}, year = {2009} }

TY - JOUR ID - citeulike:3974602 L3 - citeulike-article-id:3974602 N2 - Background: Heart failure (HF) is an important cause of morbidity in patients with acute coronary syndromes (ACS). C-reactive protein (CRP) has been implicated in experimental models as exacerbating myocardial injury, but data regarding the clinical relationship of high-sensitivity CRP (hsCRP) and B-type natriuretic peptide (BNP) concentrations with the risk of HF after ACS are few. Methods: PROVE IT-TIMI 22 randomized 4162 patients who had been stabilized after ACS to either intensive or moderate statin therapy. hsCRP and BNP were measured 30 days after randomization. Hospitalizations for HF and cardiovascular death occurring after day 30 were assessed for a mean follow-up of 24 months. Results: Patients who developed HF had higher concentrations of hsCRP (3.7 mg/L vs 1.9 mg/L, P < 0.001) and BNP (59 ng/L vs 22 ng/L, P < 0.0001). HF increased in a stepwise manner with hsCRP quartile [adjusted hazard ratio (HRadj) for Q4 vs Q1, 2.5; P = 0.01] and BNP quartile (HRadj for Q4 vs Q1, 5.8; P < 0.001), with similar results obtained for HF and cardiovascular death. In a multivariable analysis, higher concentrations of hsCRP and BNP were both independently associated with HF [HRadj, 1.9 for hsCRP >2.0 mg/L (P = 0.01) and 4.2 for BNP >80 ng/L (P < 0.001)]. Patients with increases in both markers were at the greatest risk of HF, compared with patients without an increased marker concentration (HRadj, 8.3; P = 0.01). The benefit of intensive statin therapy in reducing HF was consistent among all patients, regardless of hsCRP or BNP concentration. Conclusions: Both hsCRP and BNP measured 30 days after ACS are independently associated with the risk of HF and cardiovascular death, with the greatest risk occurring when both markers are increased. 10.1373/clinchem.2008.117192 IS - 2 JF - Clin Chem EP - 273 TI - Concentrations of C-Reactive Protein and B-Type Natriuretic Peptide 30 Days after Acute Coronary Syndromes Independently Predict Hospitalization for Heart Failure and Cardiovascular Death VL - 55 SP - 265 KW - c-reactive-protein KW - cardiovascular-disease KW - heart-failure AU - Scirica, Benjamin AU - Cannon, Christopher AU - Sabatine, Marc AU - Jarolim, Petr AU - Sloane, Sarah AU - Rifai, Nader AU - Braunwald, Eugene AU - Morrow, David AU - For PY - 2009/02/01/ UR - http://dx.doi.org/10.1373/clinchem.2008.117192 ER -