Abstract 18131: Elevated High-sensitivity C-reactive Protein as a Risk Factor for Adverse Outcomes of Hypertrophic Cardiomyopathy

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a clinically heterogeneous disease with a diverse prognosis. Recent studies suggest that inflammatory response may play a significant role in the phenotypic expression of HCM. Elevated C-reactive protein (CRP), an important biomarker of inflammation for clinical application, has been associated with increased risk of various cardiovascular diseases. However, the relationship between high-sensitivity CRP (hsCRP) and the prognosis of HCM has not yet been evaluated.

Objectives: To evaluate clinical implication of serum levels of hsCRP on the prognosis of patients with HCM.

Methods and Results: A total of 471 patients were enrolled in FuWai hospital from April 2001 to May 2011.The circulating levels of hsCRP were measured at enrollment. During the follow-up of 3.5±1.8years, 32 patients had all-cause mortality and 27 developed cardiovascular death, including 10 SCD, 13 heart failure-related and 4 fatal stroke-related deaths. According to tertiles of hsCRP, subjects in the highest tertile (>1.93mg/L) had a higher risk of developing cardiovascular death than the first hsCRP tertile (<0.78 mg/L)(HR,6.19;95% CI,1.78-21.54; P=0.004) after adjustment for multiple factors, including a family history of SCD, unexplained syncope, rest left ventricular outflow tract obstruction, maximal left ventricular wall thickness, age, gender, body mass index , heart failure, atrial fibrillation , stroke, coronary heart disease,and diabetes. When analyzed as a continuous variable and adjusted for multiple factors, elevated hsCRP predicted increased risk for cardiovascular death (HR, 1.10; 95% CI, 1.03-1.18; P=0.004). The relative risk of hsCRP, as a continuous variable, was up to1.19(95% CI, 1.07-1.32; P=0.002)after excluding heart failure, stroke, coronary heart disease,and diabetes, which could affect the cardiovascular death. The ROC analysis indicated that hsCRP had reasonable accuracy for prediction of cardiovascular death (the area under curves, 0.70; 95% CI, 0.61-0.79; P<0.001).

Conclusions: Our results suggest that elevated level of hsCRP predicts high risk of cardiovascular death in HCM.