Opotowsky AR, et al. - A prospective cohort study was conducted to investigate the clinical correlates and prognostic value of high-sensitivity C-reactive protein (hsCRP) levels in adults with congenital heart disease (ACHD). Researchers reported that adults with congenital heart disease with elevated hsCRP have worse functional status and exercise capacity as well as greater risk for death or non-elective cardiovascular hospitalization.

Methods

• Between 2012 and 2016, researchers conducted a prospective cohort study of (n=707) outpatient ACHD (age 39 ± 14 years, 49% women), enlisted mainly at a referral center, who had serum hsCRP measured in conjunction with a clinical assessment.
• Clinical correlates of hsCRP and its relationship with adverse events including the primary combined outcome of all-cause mortality or non-elective cardiovascular hospitalization were analyzed.

Results

• According to the findings obtained, higher hsCRP was strongly correlated with measures of functional status including New York Heart Association class and peak VO₂, and with comorbidities like atrial arrhythmia.
• One hundred fourteen patients (16%) experienced the primary outcome, including 29 deaths during average follow-up of 815 ± 536 days.
• Findings revealed that having elevated hsCRP, in the highest (≥ 2.98 mg/L) compared with the lower three quartiles, conferred increased risk for the primary outcome (30.5% vs 11.3%, adjusted hazard ratio [HR] = 2.00, 95% confidence interval [CI] 1.35–2.97; P=0.0006) and all-cause mortality (11.9% vs 1.5%, adjusted HR=4.23, 95% CI 1.87–9.59; P=0.0006).
• The study results showed that elevated hsCRP was correlated with adverse outcomes across ACHD subgroups and other patient characteristics.