Abstract 13943: High-Sensitive C-Reactive Protein is a Valid Marker for the Short-Term Prediction of an Adverse Outcome in Patients with Cardiac Chief in the Emergency Department
Introduction: High sensitive C-reactive Protein (hsCRP) is associated with a high risk of adverse outcome in various pathological conditions and even in healthy subjects. We assessed the utility of hsCRP to predict the short term outcome in unselected patients who attend the Emergendy Department (ED) with acute cardiac chief complaints. Hypothesis: hsCRP may be a predictor of adverse outcome in patients with cardiac chief complaints in the ED.
Methods: Patients with chest pain and dyspnea were enrolled over a period of 30 months in the Emergency Department. Blood samples were drawn within 2 hours after admission and, in patients with chest pain, again six hours later. Outcome measures were assessed after 3 months. Variables are shown as median (IQR).
Results: Overall 537 patients were enrolled in this study. hsCRP-values at admission were significantly higher in patients with dyspnea (0.65/0.19-2.38mg/dl) compared to patients with chest pain (0.27/0.10-0.81 mg/dl; p<0.0001). The mortality-rate in all patients was 3.4% (n=23), 18.1% were rehospitalized (n=97). Patients who died had significantly higher values of hsCRP compared to survivors (p<0.0001; see also figure 1). There was no significant difference between patients who were rehospitalized and patients who were not (p=0.086). In ROC-analysis hsCRP had an area under the curve of 0.759 (CI: 0.662-0.856; p<0.0001) for the prediction of a fatal outcome. Patients with hsCRP above the optimized cut-off of 1.5 mg/dl had an OR of 5.9 (2.4-14.2) to die within the FU-period.
Conclusions: hsCRP is a valid marker for short-term prediction of fatal outcome in unselected patients with cardiac chief complaints in the ED and may be useful in ED-processes as a marker of early risk-stratification.
- © 2012 by American Heart Association, Inc.