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CRP Levels (crp + level)
Kinds of CRP Levels Selected AbstractsAssociation of Common CRP Gene Variants with CRP Levels and Cardiovascular EventsANNALS OF HUMAN GENETICS, Issue 6 2005D. T. Miller Summary C-reactive protein (CRP) is a well-documented marker of atherosclerotic cardiovascular disease risk. We resequenced CRP to identify a comprehensive set of common SNP variants, then studied and replicated their association with baseline CRP level among apparently healthy subjects in the Women's Health Study (WHS; n = 717), Pravastatin Inflammation/CRP Evaluation trial (PRINCE; n = 1,110) and Physicians' Health Study (PHS; n = 509) cohorts. The minor alleles of four SNPs were consistently associated in all three cohorts with higher CRP, while the minor alleles of two SNPs were associated with lower CRP (p < 0.05 for each). Single marker and haplotype analysis in all three cohorts were consistent with functional roles for the 5,-flanking triallelic SNP ,286C>T>A and the 3,-UTR SNP 1846G>A. None of the SNPs associated with higher CRP were associated with risk of incident myocardial infarction (MI) or ischemic stroke in a prospective, nested case-control study design from the PHS cohort (610 case-control pairs). One SNP, ,717A>G, was unrelated to CRP levels but associated with decreased risk of MI (p = 0.001). Taken together, these data imply significant interactions between both genetic and environmental contributions to the increased CRP levels that predict a greater risk of future atherothrombotic events in epidemiological studies. [source] Quality of life in chronic kidney disease: effects of treatment modality, depression, malnutrition and inflammationINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2007B. Kalender Summary In the present study, our aim is to investigate the effects of the treatment modality, depression, malnutrition and inflammation on quality of life (QoL) in chronic kidney disease (CKD). Twenty-six patients with CKD on conservative management, 68 patients on haemodialysis (HD), 47 patients on continuous ambulatory peritoneal dialysis (CAPD) and 66 healthy controls were enrolled in the study. QoL was measured by means of the Short Form-36 (SF-36) and subscale scores were calculated. All patients were evaluated for the presence of depression using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders , Clinician Version. The severity of depression was evaluated by means of the Beck Depression Inventory (BDI). Serum C-reactive protein (CRP), ferritin, albumin, haemoglobin and haematocrit (Hct) levels were measured. All the SF-36 subscale scores were lower in the patient groups compared with control group. The SF-36 scores were higher and BDI scores were lower in the CAPD group than CKD and HD groups. In patients with depression, all SF-36 subscale scores were lower than that of the patients without depression. There was a significant negative correlation between all the SF-36 subscale scores and the BDI scores. There was a significant positive correlation between the SF-36 physical and total summary scores and the Hct value and serum albumin levels, but an inverse correlation between the SF-36 physical, mental and total summary scores and the serum CRP level in the HD patients. The authors suggest that the treatment modality, depression, malnutrition and inflammation have an important role on QoL in CKD. [source] C-reactive protein levels and common polymorphisms of the interleukin-1 gene cluster and interleukin-6 gene in patients with coronary heart diseaseINTERNATIONAL JOURNAL OF IMMUNOGENETICS, Issue 5 2004G. Latkovskis Summary C-reactive protein (CRP) is an inflammatory marker associated with increased cardiovascular risk. Production of CRP is regulated by interleukin (IL)-1,, IL-1 receptor antagonist and IL-6. In 160 patients with coronary heart disease (CHD) confirmed by angiography, we examined the relationship between CRP level and five polymorphisms in genes coding for these cytokines: IL-1B(,511), IL-1B(+3954), a variable number tandem repeat (VNTR) polymorphism in intron 2 of IL-1RN [IL-1RN(VNTR)], IL-6(,174) and IL-6(,572). CRP values were logarithmically normalized (log-CRP) for statistical calculations. In univariate analysis, carrier status for the IL-1B(+3954)T allele and IL-1RN(VNTR) allele 2 [IL-1RN(VNTR)*2] correlated with higher (P < 0.01) and lower (P < 0.05) log-CRP values, respectively. Among the potential confounding factors analysed, smoking, body mass index, total cholesterol (P < 0.05 for all) and diabetes (P = 0.056) were positively correlated with CRP level. After adjustment for non-genetic covariates, CRP levels remained significantly (P < 0.01) higher in carriers of IL-1B(+3954)T than in non-carriers: mean log-CRP (with 95% confidence interval) was 0.443 (0.311,0.574) for CT or TT genotypes compared with 0.240 (0.107,0.373) for the CC genotype, which corresponded to back-transformed CRP levels of 2.77 and 1.74 mg l,1, respectively. Adjusted association was also significant for IL-1RN(VNTR)*2 (P < 0.01), with lower CRP levels in the presence of allele 2: the mean log-CRP value was 0.252 (0.115,0.388) for carriers and 0.421 (0.290,0.552) for non-carriers (CRP 1.79 and 2.64 mg l,1, respectively). When alleles of both polymorphisms were entered into the model simultaneously, the association remained significant for IL-1B(+3954)T (P < 0.05), but not for IL-1RN(VNTR)*2. We conclude that IL-1B(+3954)T is associated with higher CRP levels in patients with CHD, and we found that this association was significant after adjustment for major risk factors. Our data also suggest a possible relationship of IL-1RN(VNTR)*2 with lower CRP levels in the same patients. [source] Impact of thrombocytosis and C-reactive protein elevation on the prognosis for patients with renal cell carcinomaINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2006KEIICHI ITO Aim: C-reactive protein (CRP) elevation is reportedly a prognostic factor in patients with renal cell carcinoma (RCC). Thrombocytosis has recently been reported also to be a prognostic factor in RCC and, like CRP, to be related to inflammatory cytokines such as interleukin-6. The aim of this study was to evaluate the importance of both thrombocytosis and CRP elevation in tumor recurrence and prognosis for patients with RCC. Methods: The clinical records of 178 patients who underwent radical nephrectomy were reviewed. Thrombocytosis was defined as a platelet count ,350 000/mm3, and CRP elevation was defined as a CRP level ,1.0 mg/dL. Disease-free survival and cause-specific survival rates were calculated. Independent predictors for recurrence and prognosis were determined. Results: Patients with thrombocytosis and patients with elevated CRP levels had significantly higher pathological T stage, clinical stage, tumor size, histological grade, and percentage of microvascular invasion than did patients without THC and patients with CRP levels <1.0 mg/dL, respectively. There was a significant correlation between platelet counts and CRP levels. Multivariate analysis showed that distant metastasis, tumor size, grade 3 components, and CRP elevation were independent predictors for prognosis but thrombocytosis was not. In N0M0 RCC patients, tumor size, microvascular invasion, and CRP elevation were independent predictors for recurrence. CRP elevation and tumor size were independent predictors for prognosis. Conclusions: Platelet count and CRP level are strongly correlated in patients with RCC, but only CRP elevation is an independent predictor for recurrence and prognosis. [source] Association of salivary lysozyme and C-reactive protein with metabolic syndromeJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2010Markku Qvarnstrom Qvarnstrom M, Janket S-J, Jones JA, Jethwani K, Nuutinen P, Garcia RI, Baird AE, Van Dyke TE and Meurman JH. Association of salivary lysozyme and C-reactive protein with metabolic syndrome. J Clin Periodontol 2010; 37: 805,811. doi: 10.1111/j.1600-051X.2010.01605.x. Abstract Introduction: Salivary lysozyme (SLZ) is a proteolytic enzyme secreted by oral leucocytes and contains a domain that has an affinity to advanced glycation end products (AGE). Thus, we hypothesized that SLZ would be associated with metabolic syndrome (metS), a pro-inflammatory state. Methods: Utilizing cross-sectional data from 250 coronary artery disease (CAD) and 250 non-CAD patients, the association of SLZ with metS was tested by logistic regression analyses controlling for age, sex, smoking, total cholesterol and C-reactive protein (CRP) levels. The analyses were stratified by CAD status to control for the possible effects of CAD. Results: MetS was found in 122 persons. The adjusted odds ratio (OR) for metS associated with the highest quartile of SLZ was 1.95 with 95% confidence interval (CI) 1.20,3.12, p -value=0.007, compared with the lower three quartiles combined. Among the 40 subjects with metS but without CAD, the OR was 1.63 (CI: 0.64,4.15, p=0.31), whereas in the CAD group, SLZ was significantly associated with metS [OR=1.96 (1.09,3.52), p=0.02]. In both subgroups, CRP was not significantly associated with metS. Conclusion: SLZ was significantly associated with metS (OR=1.95) independent of CRP level. Future longitudinal research is warranted. [source] Aneurysms of the renal arteries associated with segmental arterial mediolysis in a case of polyarteritis nodosaPATHOLOGY INTERNATIONAL, Issue 3 2009Yoshiko Soga This is the first report of segmental arterial mediolysis (SAM) accompanied with polyarteritis nodosa (PN), and manifesting aneurysms of the renal arteries. A 73-year-old woman was admitted to hospital because of a high fever. Laboratory tests showed leukocytosis with increased CRP level in the serum. Myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) and proteinase 3 (PR3)-ANCA were negative. There were no signs indicating infection or malignancy. After admission renal function rapidly deteriorated. Treatment was then started with daily oral prednisolone and hemodialysis. On the 40th day of hospitalization the patient suddenly became comatose. Cranial CT showed a subarachnoid hemorrhage. The patient died and an autopsy was performed. The pathological findings showed necrotizing vasculitis of the small arteries in various organs, but not associated with that of arterioles or renal glomerular lesions, indicating PN. Unexpectedly, the segmental arteries of the bilateral kidneys showed vascular lesions of dissecting aneurysms, indicating SAM. This case indicates that SAM is one of the causes of aneurysms in PN and is clinically important when the clinical course of PN patients rapidly advances. [source] Association of Common CRP Gene Variants with CRP Levels and Cardiovascular EventsANNALS OF HUMAN GENETICS, Issue 6 2005D. T. Miller Summary C-reactive protein (CRP) is a well-documented marker of atherosclerotic cardiovascular disease risk. We resequenced CRP to identify a comprehensive set of common SNP variants, then studied and replicated their association with baseline CRP level among apparently healthy subjects in the Women's Health Study (WHS; n = 717), Pravastatin Inflammation/CRP Evaluation trial (PRINCE; n = 1,110) and Physicians' Health Study (PHS; n = 509) cohorts. The minor alleles of four SNPs were consistently associated in all three cohorts with higher CRP, while the minor alleles of two SNPs were associated with lower CRP (p < 0.05 for each). Single marker and haplotype analysis in all three cohorts were consistent with functional roles for the 5,-flanking triallelic SNP ,286C>T>A and the 3,-UTR SNP 1846G>A. None of the SNPs associated with higher CRP were associated with risk of incident myocardial infarction (MI) or ischemic stroke in a prospective, nested case-control study design from the PHS cohort (610 case-control pairs). One SNP, ,717A>G, was unrelated to CRP levels but associated with decreased risk of MI (p = 0.001). Taken together, these data imply significant interactions between both genetic and environmental contributions to the increased CRP levels that predict a greater risk of future atherothrombotic events in epidemiological studies. [source] The early disease stage in axial spondylarthritis: Results from the german spondyloarthritis inception cohort,ARTHRITIS & RHEUMATISM, Issue 3 2009Martin Rudwaleit Objective Ankylosing spondylitis (AS) is diagnosed late, because radiographs of the sacroiliac joints often do not show definite sacroiliitis at the time of disease onset. The aim of this study was to investigate whether patients without definite radiographically defined sacroiliitis, referred to as nonradiographic axial spondylarthritis (SpA), are different from patients with AS with regard to clinical manifestations and disease activity measures. Moreover, we sought to identify determinants of the development of radiographic sacroiliitis. Methods In a cross-sectional analysis of 462 patients, we compared 226 patients with nonradiographic axial SpA (symptom duration ,5 years) and 236 patients with AS (symptom duration ,10 years) who are participants in the German Spondyloarthritis Inception Cohort. Radiographs of the sacroiliac joints and the spine were assessed by 2 readers in a blinded manner. Logistic regression analysis was applied to identify parameters associated with structural damage. Results The 2 groups did not differ in the frequency of HLA,B27 positivity, inflammatory back pain, arthritis, enthesitis, and uveitis and had similar levels of disease activity, using measures such as the Bath Ankylosing Spondylitis Disease Activity Index. In both groups, HLA,B27 positivity determined the age at disease onset. Male sex (adjusted odds ratio [OR] 2.38, 95% confidence interval [95% CI] 1.19,4.73 [P = 0.014]) and an elevated C-reactive protein (CRP) level (adjusted OR 1.85, 95% CI 0.96,3.56 [P = 0.066]) were associated with radiographic sacroiliitis. In patients with AS, male sex and an elevated CRP level were also associated with the presence of syndesmophytes. Conclusion Clinical manifestations and disease activity measures are highly comparable between patients with early nonradiographic axial SpA and those with early AS, suggesting that these 2 entities are part of the same disease. Male sex and an elevated CRP level are associated with structural damage on radiographs, whereas HLA,B27 positivity determines the age at disease onset. [source] Inflammation and bone resorption as independent factors of accelerated arterial wall thickening in patients with rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 11 2003Mayumi Nagata-Sakurai Objective We recently reported that rheumatoid arthritis (RA) patients had increased intima-media thickness (IMT) of the common carotid artery (CCA). The present longitudinal study was performed to determine whether the change in arterial thickness was accelerated in RA patients and to determine which factor was important in the progression of arterial wall changes. Methods We studied 62 female RA patients with stable disease activity and 63 healthy female controls. IMT of the CCA was measured twice by high-resolution B-mode ultrasonography. The second examination was performed 18,36 months after the first, and changes were expressed as millimeters of increase per year. Baseline examinations included blood markers of inflammation and urinary calcium excretion (expressed as the calcium-to-creatinine ratio). Results RA patients showed a significantly greater increase in IMT of the CCA compared with controls. In univariate analyses of the RA patient data, the C-reactive protein (CRP) level correlated with the increase in CCA IMT. Other markers of inflammation (the erythrocyte sedimentation rate and white blood cell and platelet counts) also showed significant positive associations with the annual increase in CCA IMT in multiple regression models when adjusted for age, smoking status, blood pressure, and serum cholesterol level. The urinary calcium-to-creatinine ratio was also significantly associated with an increase in CCA IMT. Moreover, both the CRP level and the urinary calcium-to-creatinine ratio were significantly and independently associated with the increase in IMT of the CCA. Conclusion Patients with RA have a higher rate of increase in thickening of the arterial wall. Inflammation and calcium mobilization are factors closely associated with the accelerated arterial wall changes. [source] Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 7 2003Fiona M. McQueen Objective Magnetic resonance imaging (MRI) is capable of revealing synovitis and tendinitis in early rheumatoid arthritis (RA), as well as bone edema and erosion. These features are visible before radiographic joint damage occurs. We sought to examine whether MRI of one body region (the wrist) can be used to predict whole-body radiography scores reflecting joint damage at 6 years. Methods We conducted a 6-year prospective study of a cohort of patients who fulfilled the criteria for RA at presentation, using clinical parameters, radiographs, and MRI scans of the dominant wrist. Of the 42 patients enrolled at baseline, full MRI, radiographic, and clinical data were available for 31 at 6-year followup. MRI scans were scored by 2 radiologists, using a validated scoring system. Radiographs of the hands and feet were graded using the modified Sharp scoring method. MRI and radiography scores obtained at baseline and 6 years were compared, and baseline MRI scores were examined for their ability to predict radiographic outcome at 6 years. Results At 6 years, the total Sharp score correlated significantly with the total MRI score and the MRI erosion score (r = 0.81, P < 0.0001 and r = 0.79, P < 0.0001, respectively). The 6-year Sharp score also correlated with the baseline total MRI and MRI erosion scores (r = 0.56, P < 0.0001 and r = 0.33, P = 0.03, respectively). MRI synovitis and bone edema scores remained constant for the group as a whole over 6 years, but bone erosion scores progressed (P = 0.0001), consistent with radiographic deterioration. Erosions on 6-year MRI scans were frequently preceded by MRI bone edema at baseline (odds ratio 6.5, 95% confidence interval 2.78,18.1). Regression models indicated that the baseline MRI bone edema score was predictive of the 6-year total Sharp score (P = 0.01), as was the C-reactive protein (CRP) level (P = 0.0002). Neither shared epitope status nor swollen or tender joint counts predicted radiographic outcome in this cohort. A model incorporating baseline MRI scores for erosion, bone edema, synovitis, and tendinitis plus the CRP level and the erythrocyte sedimentation rate explained 59% of the variance in the 6-year total Sharp score (R2 = 0.59, adjusted R2 = 0.44). Conclusion MRI scans performed at the first presentation of RA can be used to help predict future radiographic damage, allowing disease-modifying therapy to be targeted to patients with aggressive disease. [source] Antibody responses to Porphyromonas gingivalis outer membrane protein in the first trimesterAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2009Jun SASAHARA Background:,Porphyromonas gingivalis (Pg) is one of the most harmful periodontal pathogens and it has been reported that Pg is associated with preterm birth (PTB), intrauterine growth retardation (IUGR) and pregnancy-induced hypertension (PIH), discovered by animal experiments and clinical research. The relationship between adverse pregnancy outcomes and maternal antibody response to Pg is controversial. On the other hand, the serum C-reactive protein (CRP) has been recognised as a reliable serum marker of periodontal disease. Aims:, To determine the significance of antibody responses to Pg affecting pregnancy outcomes in the first trimester. Methods:, A case,control study was carried out on women with PTB (n = 58), IUGR (n = 91), PIH (n = 32) and without any complications (control, n = 98). The serum level of the CRP and IgG1 against 40-kDa outer membrane protein of Pg (anti-40-kDa OMP Pg -IgG1) in the first trimester was measured. Results:, The IUGR group, and PTB patients whose placentas were diagnosed as chorioamnionitis or whose vaginal flora included Lactobacilli, showed a lower level of anti-40-kDa OMP Pg -IgG1 than the control group. There was no difference in the serum CRP level between each case group and control group. Conclusions:, These results suggest that a lack of humoral immunity against Pg in early pregnancy is associated with IUGR and some PTB. [source] Preoperative but not postoperative systemic inflammatory response correlates with survival in colorectal cancer,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2007J. E. M. Crozier Background: The aim of the present study was to evaluate the relationship between the preoperative and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for colorectal cancer. Methods: One hundred and eighty patients with colorectal cancer were studied. Circulating concentrations of C-reactive protein (CRP) were measured before surgery and in the immediate postoperative period. Results: The peak in CRP concentration occurred on day 2 (P < 0·001). During the course of the study 59 patients died, 30 from cancer and 29 from intercurrent disease. Day 2 CRP concentrations were dichotomized. In univariable analysis, advanced tumour node metastasis stage (P = 0·002), a raised preoperative CRP level (P < 0·001) and the presence of hypoalbuminaemia (P = 0·043) were associated with poorer cancer-specific survival. Conclusion: Preoperative but not postoperative CRP concentrations are associated with poor tumour-specific survival in patients undergoing potentially curative resection for colorectal cancer. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2006R. Mofidi Background: Mortality in patients with acute pancreatitis is associated with the number of failing organs and the severity and reversibility of organ dysfunction. The aim of this study was to assess the significance of early systemic inflammatory response syndrome (SIRS) in the development of multiorgan dysfunction syndrome (MODS) and death from acute pancreatitis. Methods: Data for all patients with a diagnosis of acute pancreatitis between January 2000 and December 2004 were reviewed. Serum C-reactive protein (CRP), Acute Physiology And Chronic Health Evaluation (APACHE) II scores and presence of SIRS were recorded on admission and at 48 h. Marshall organ dysfunction scores were calculated during the first week of presentation. Presence of SIRS and raised serum CRP levels on admission and at 48 h were correlated with the cumulative organ dysfunction scores in the first week. Results: A total of 759 patients with acute pancreatitis were identified, of whom 45 (5·9 per cent) died during the index admission. SIRS was identified in 162 patients on admission and was persistent in 138 at 48 h. The median (range) cumulative Marshall score in patients with persistent SIRS was significantly higher than that in patients in whom SIRS resolved and in those with no SIRS (4 (0,12), 3 (0,7) and 0 (0,9) respectively; P < 0·001). Thirty-five patients (25·4 per cent) with persistent SIRS died from acute pancreatitis, compared with six patients (8 per cent) with transient SIRS and four (0·7 per cent) without SIRS (P < 0·001). No correlation was observed between CRP level on admission and Marshall score (P = 0·810); however, there was a close correlation between CRP level at 48 h and Marshall score (P < 0·001). Conclusion: Persistent SIRS is associated with MODS and death in patients with acute pancreatitis and is an early indicator of the likely severity of acute pancreatitis. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Relationship of carotenoid and vitamins A and E with the acute inflammatory response in acute pancreatitisBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2000F. J. M. Curran Background: Inflammation and oxidative stress are believed to be important in the development of the systemic complications of acute pancreatitis. The fat-soluble vitamins A and E, and the carotenoids have antioxidant properties. The aim of this study was to assess the effect of acute pancreatitis on serum concentrations of vitamin antioxidants and to relate such changes to the degree of the inflammatory response. Methods: Thirteen consecutive patients with predicted severe acute pancreatitis were compared with 26 matched healthy controls. Five patients developed severe acute pancreatitis and three of these died. Vitamin antioxidant and C-reactive protein (CRP) levels were measured daily for up to 7 days. Results: Patients had significantly lower levels of antioxidants throughout the course of the study (P < 0·017). In patients there was a significant correlation between peak CRP and trough antioxidant levels (P < 0·01). In patients with mild acute pancreatitis, the concentrations of retinol and ,-carotene at final review were significantly higher than those in patients with severe acute pancreatitis (P < 0·05). This coincided with a reduction in CRP level. Conclusion: In acute pancreatitis, circulating concentrations of vitamin antioxidants are reduced and are inversely related to the rise in CRP level. © 2000 British Journal of Surgery Society Ltd [source] C-reactive protein as a marker of serious bacterial infections in hospitalized febrile infantsACTA PAEDIATRICA, Issue 11 2009Efraim Bilavsky Abstract Objective:, To determine the potential predictive power of C-reactive protein (CRP) as a marker of serious bacterial infection (SBI) in hospitalized febrile infants aged ,3 months. Patients and Methods:, Data on blood CRP levels were collected prospectively on admission for all infants aged ,3 months who were hospitalized for fever from 2005 to 2008. The patients were divided into two groups by the presence or absence of findings of SBI. Results:, A total of 892 infants met the inclusion criteria, of whom 102 had a SBI. Mean CRP level was significantly higher in the infants who had a bacterial infection than in those who did not (5.3 ± 6.3 mg/dL vs. 1.3 ± 2.2 mg/dL, p < 0.001). The area under the ROC curve (AUC) was 0.74 (95% CI: 0.67,0.80) for CRP compared to 0.70 (95% CI: 0.64,0.76) for white blood cell (WBC) count. When analyses were limited to predicting bacteremia or meningitis only, the AUCs for CRP and WBC were 0.81 (95% CI: 0.66,0.96) and 0.63 (95% CI: 0.42,0.83), respectively. Conclusion:, C-reactive protein is a valuable laboratory test in the assessment of febrile infants aged ,3 months old and may serve as a better diagnostic marker of SBI than total WBC count. [source] C,Reactive Protein and Atrial Fibrillation in Idiopathic Dilated CardiomyopathyCLINICAL CARDIOLOGY, Issue 9 2009Shimo MD Background Previous studies have found elevated plasma C-reactive protein (CRP) levels in atrial fibrillation (AF) patients. Most of these studies included AF patients with various heart diseases, but few studies were designed to investigate CRP in idiopathic dilated cardiomyopathy (IDCM) patients with AF. Method and Results CRP levels in 242 IDCM patients with AF were compared with CRP levels in 280 control IDCM patients. Among control patients, 70 had atrial premature beats or atrial tachycardia and 210 had normal sinus rhythm. CRP was higher in the AF group than in the control group (median, 4.59 versus 2.81 mg/L; p < 0.001). The prevalence of AF in IDCM patients increased as plasma CRP levels increased, and the patients with the highest plasma CRP levels had the highest probability of suffering from AF. Outcome of multivariate logistic regression analysis showed body mass index, AF, and white blood cell count significantly correlated with the plasma CRP levels. Conclusion Our data demonstrated that the plasma CRP level in IDCM patients with AF was higher than in IDCM patients without AF, and an increase in plasma CRP levels was associated with an increased prevalence of AF in IDCM patients. Also, body mass index, AF, and white blood cell count correlate with plasma CRP levels in IDCM patients. These data suggest there is presence of inflammation in IDCM patients with AF. Copyright © 2009 Wiley Periodicals, Inc. [source] Preoperative blood sugar and C-reactive protein associated with persistent discharge after incision and drainage for patients with deep neck abscessesCLINICAL OTOLARYNGOLOGY, Issue 4 2009S.-A. Liu Objectives:, The aim of this study was to investigate whether preoperative C-reactive protein (CRP) and blood sugar correlated with persistent discharge after incision and drainage for patients with deep neck abscesses. Study design:, Retrospective data analysis. Setting:, Tertiary referral centre. Participants:, A total of 204 patients who underwent operation for deep neck abscess. Main outcome measures:, Persistent discharge after operation. Results:, One hundred seventy patients were included for final analyses. Most of the patients were male (n = 115; 68%) and the average age was 54 years. Using logistic regression analyses, age >55 years [odds ratio (OR): 3.053; P = 0.002], preoperative CRP >15 mg/dL (OR: 2.174; P = 0.027), and preoperative blood sugar >8.3 mmol/L (OR: 3.280; P = 0.001) were independent factors correlated with persistent discharge. Conclusions:, Older age, elevated preoperative CRP level and blood sugar had a statistically significant association with persistent discharge after operation in deep neck abscesses patients. [source] Elevated C-reactive protein in Native Canadian children: an ominous early complication of childhood obesityDIABETES OBESITY & METABOLISM, Issue 5 2006R. Retnakaran Aim:, Subclinical inflammation has been proposed as a pathophysiologic mechanism linking obesity with vascular and metabolic disease. Native North American populations are experiencing high prevalence rates of both (i) childhood obesity and (ii) adult cardiovascular disease (CVD) and type 2 diabetes. Thus, we sought to determine whether subclinical inflammation is an early complication of obesity in Native children. Methods:, Serum concentrations of the inflammatory biomarker C-reactive protein (CRP) were assessed in a population-based, cross-sectional study of the Sandy Lake Oji-Cree community of Northern Ontario, Canada, involving 228 children aged 10,19 years (mean age 14.8). Results:, Median CRP in this population was 0.5 mg/l (interquartile range 0.18,1.79 mg/l). CRP levels were higher than age-matched reference data from the Third National Health and Nutrition Examination Survey (NHANES III). Importantly, fully 15.8% of the children of this community had CRP concentrations between 3 and 10 mg/l, a range that identifies adults at high risk of CVD. Moreover, increasing CRP concentration in this paediatric population was associated with an enhanced CV risk profile, consisting of increased adiposity, higher insulin resistance, worsening lipid profile (higher total cholesterol, triglycerides, low-density lipoprotein cholesterol, apolipoprotein B and total cholesterol : high-density-lipoprotein cholesterol ratio), increased leptin and decreased adiponectin. On multivariate analysis, waist circumference and interleukin-6 (IL-6) emerged as independent determinants of CRP concentration. Conclusion:, Subclinical inflammation is an early complication of childhood obesity in Native children and may foreshadow an increased burden of CVD and type 2 diabetes in the future. [source] C-Reactive Protein and Aortic Stiffness in Patients with Idiopathic Dilated CardiomyopathyECHOCARDIOGRAPHY, Issue 1 2007Feridun Kosar M.D. Background: Previous studies have shown an association between C-reactive protein (CRP)and arterial stiffness in most cardiovascular diseases. Increased CRP levels and arterial stiffness have been considered independent predictors of cardiovascular mortality in cardiovascular disease and even in the general population. Objective: The aim of this study was to investigate the relationship between CRP, a marker of systemic inflammation and aortic stiffness in patients with idiopathic dilated cardiomyopathy (DCMP). Methods: Serum CRP levels and aortic stiffness parameters were measured in DCMP patients (n= 37) and age- and gender-matched control subjects (n= 30). High-sensitivity CRP levels were determined by an immunonephelometry assay. Aortic strain (AS) and aortic distensibility (AD) were calculated from the aortic diameters measured using M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: Serum levels of CRP in DCMP patients were higher than in the control subjects (5.47 ± 2.06 mg/L and 2.35 ± 0.47 mg/L, P < 0.001, respectively). AS and AD were significantly decreased in DCMP patients compared to the controls (P < 0.001 and P < 0.001, respectively). There were positive correlations between CRP, and (r = 0.3.64, P = 0.027) smoking (r = 0.3.56, P = 0.024), and increasing age (r = 0.587, P < 0.001), and negative correlations between CRP, and DBP (r =,0.485, P < 0.001), diameter change (DC; r =,0.493, P < 0.001), AS (r =,0.526, P < 0.001), and AD (r =,0.626, P < 0.001). Conclusion: We have shown that there is a significant relation between high serum CRP levels and impaired aortic stiffness in patients with idiopathic DCMP. These findings may indicate an important role of CRP in the pathogenesis of impaired aortic stiffness in idiopathic DCMP. [source] Inflammation reduces HDL protection against primary cardiac riskEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 6 2010James P. Corsetti Eur J Clin Invest 2010; 40 (6): 483,489 Abstract Background, We recently reported high high-density lipoprotein (HDL) cholesterol as a predictor of recurrent risk in a subgroup of postinfarction patients defined by hypercholesterolemia and high C-reactive protein (CRP) levels. We investigated whether a similar high-risk subgroup might exist for incident cardiovascular disease. Material and Methods, A graphical exploratory data analysis tool was used to identify high-risk subgroups in a male population-based cohort (n = 3405) from the prevention of renal and vascular end-stage disease study by generating 3-dimensional mappings of risk over the HDL-cholesterol/CRP domain with subsequent use of Kaplan,Meier analysis to verify high-risk. Within-subgroup risk was assessed using Cox proportional hazards regression and Kaplan,Meier analysis. Results, Mappings revealed two high-risk subgroups: a low HDL-cholesterol/high CRP subgroup and a high HDL-cholesterol/high CRP subgroup. The low HDL-cholesterol subgroup demonstrated a pattern of metabolic syndrome dyslipidemia contrasted with a predominantly unremarkable biomarker pattern for the high HDL-cholesterol subgroup. However, in the high HDL-cholesterol subgroup, CRP levels were higher than the low HDL-cholesterol subgroup; and within the high HDL-cholesterol subgroup, CRP predicted risk. Moreover, in the high HDL-cholesterol subgroup, risk was associated with lower triglyceride levels in conjunction with presumptively larger HDL particles. Conclusions, High HDL-cholesterol and high CRP levels define a subgroup of men at high-risk for incident cardiovascular disease. High HDL cholesterol-associated risk likely relates to impaired HDL particle remodelling in the setting of inflammation. This approach may facilitate identification of additional inflammation-related mechanisms underlying high HDL cholesterol-associated risk; and potentially influence management of such patients. [source] Atorvastatin therapy improves exercise oxygen uptake kinetics in post-myocardial infarction patientsEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 6 2007M. Guazzi Abstract Background Statins represent a modern mainstay of the drug treatment of coronary artery disease and acute coronary syndromes. Reduced aerobic work performance and slowed VO2 kinetics are established features of the clinical picture of post-myocardial infarction (MI) patients. We tested the hypothesis that statin therapy improves VO2 exercise performance in normocholesterolaemic post-MI patients. Materials and methods, According to a double-blinded, randomized, crossover and placebo-controlled study design, in 18 patients with uncomplicated recent (3 days) MI we investigated the effects of atorvastatin (20 mg day,1) on gas exchange kinetics by calculating VO2 effective time constant (tau) during a 50-watt constant workload exercise, brachial artery flow-mediated dilatation (FMD) as an index of endothelial function, left ventricular function (echocardiography) and C-reactive protein (CRP, as an index of inflammation). Atorvastatin or placebo was given for 3 months each. Results, Atorvastatin therapy significantly improved exercise VO2 tau and FMD, and reduced CRP levels. We did not observe changes in cardiac contractile function and relaxation properties during all study periods in either group. Conclusions, In post-MI patients exercise performance is a potential additional target of benefits related to statin therapy. Endothelial function improvement is very likely implicated in this newly described therapeutic property. [source] Aspirin reduces anticardiolipin antibodies in patients with coronary artery diseaseEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 12 2006I. Ikonomidis Abstract Background, Anticardiolipin antibodies (aCL) have been found to be elevated in patients with coronary artery disease (CAD) and have been associated with an adverse outcome owing to their prothrombotic activity. The aim of this study was to investigate the effect of aspirin treatment on aCL levels in patients with chronic CAD. Materials and methods, Forty patients with chronic CAD scheduled for elective coronary artery bypass graft surgery (CABG) and 40 healthy controls participated in the study. Patients were treated with 300 mg of aspirin once daily (o.d.) for the first 12 days and placebo for the following 12 days before CABG in a double-blind, cross-over trial. Immunoglobulin (Ig) G-, IgM-, IgA-aCL and C-reactive protein (CRP) levels were measured in the controls and at the end of each treatment period in the patients with CAD. Results, The IgA- and IgG-aCL levels were greater in patients with CAD than in the controls. Compared with the placebo, IgA, IgG subtypes and CRP levels were reduced after aspirin treatment (P = 0·001, P = 0·02, P = 0·04, respectively). The percentage reduction of IgA- and IgG-aCL was related to the percentage reduction of CRP after aspirin (P < 0·05). Conclusion, Aspirin treatment with 300 mg o.d. reduced the serum levels of IgA and IgG subtypes in patients with chronic CAD in parallel to a reduction in CRP. These findings offer an additional pathophysiological mechanism of the beneficial effects of aspirin in patients with chronic CAD. [source] Determinants of C-reactive protein in chronic hemodialysis patients: Relevance of dialysis catheter utilizationHEMODIALYSIS INTERNATIONAL, Issue 2 2008Adriana HUNG Abstract Biomarkers of inflammation, especially C-reactive protein (CRP), have been consistently shown to predict poor outcomes in chronic hemodialysis (CHD) patients. However, the determinants of CRP and the value of its monitoring in CHD patients have not been well defined. We conducted a retrospective cohort study to evaluate possible determinants of the inflammatory response in CHD patients with a focus on dialysis catheter utilization. Monthly CRP were measured in 128 prevalent CHD patients (mean age 56.6 years [range 19,90], 68% African Americans, 39% diabetics [DM]) over a mean follow-up of 12 months (range 2,26 months). There were a total of 2405 CRP measurements (median 5.7 mg/L; interquartile range [IQR] 2.4,16.6 mg/L). The presence of a dialysis catheter (p<0.002), cardiovascular disease (p=0.01), male gender (p=0.005), higher white blood cell count (p<0.0001), elevated phosphorus (p=0.03), and lower cholesterol (p=0.02) and albumin (p<0.0001) concentrations were independent predictors of elevated CRP in the multivariate analysis. Additionally, CRP levels were significantly associated with the presence of a catheter, when comparing the levels before and after catheter insertion (p=0.002) as well as before and after catheter removal (p=0.009). Our results indicate that the presence of a hemodialysis catheter is an independent determinant of an exaggerated inflammatory response in CHD patients representing a potentially modifiable risk factor. [source] Impaired intestinal iron absorption in Crohn's disease correlates with disease activity and markers of inflammationINFLAMMATORY BOWEL DISEASES, Issue 12 2006Gaith Semrin MD Abstract Background: Anemia in patients with Crohn's disease (CD) is a common problem of multifactorial origin, including blood loss, malabsorption of iron, and anemia of inflammation. Anemia of inflammation is caused by the effects of inflammatory cytokines [predominantly interleukin-6 (IL-6)] on iron transport in enterocytes and macrophages. We sought to elucidate alterations in iron absorption in pediatric patients with active and inactive CD. Methods: Nineteen subjects with CD (8 female, 11 male patients) were recruited between April 2003 and June 2004. After an overnight fast, serum iron and hemoglobin levels, serum markers of inflammation [IL-6, C-reactive protein (CRP), and erythrocyte sedimentation rate], and a urine sample for hepcidin assay were obtained at 8 am. Ferrous sulfate (1 mg/kg) was administered orally, followed by determination of serum iron concentrations hourly for 4 hours after the ingestion of iron. An area under the curve for iron absorption was calculated for each patient data set. Results: There was a strong inverse correlation between the area under the curve and IL-6 (P = 0.002) and area under the curve and CRP levels (P = 0.04). Similarly, the difference between baseline and 2-hour serum iron level (,[Fe]2hr) correlated with IL-6 (P = 0.008) and CRP (P = 0.045). When cutoff values for IL-6 (>5 pg/mL) and CRP (>1.0 mg/dL) were used, urine hepcidin levels also positively correlated with IL-6 and CRP levels (P = 0.003 and 0.007, respectively). Conclusions: Subjects with active CD have impaired oral iron absorption and elevated IL-6 levels compared with subjects with inactive disease. These findings suggest that oral iron may be of limited benefit to these patients. Future study is needed to define the molecular basis for impaired iron absorption. [source] C-reactive protein levels and common polymorphisms of the interleukin-1 gene cluster and interleukin-6 gene in patients with coronary heart diseaseINTERNATIONAL JOURNAL OF IMMUNOGENETICS, Issue 5 2004G. Latkovskis Summary C-reactive protein (CRP) is an inflammatory marker associated with increased cardiovascular risk. Production of CRP is regulated by interleukin (IL)-1,, IL-1 receptor antagonist and IL-6. In 160 patients with coronary heart disease (CHD) confirmed by angiography, we examined the relationship between CRP level and five polymorphisms in genes coding for these cytokines: IL-1B(,511), IL-1B(+3954), a variable number tandem repeat (VNTR) polymorphism in intron 2 of IL-1RN [IL-1RN(VNTR)], IL-6(,174) and IL-6(,572). CRP values were logarithmically normalized (log-CRP) for statistical calculations. In univariate analysis, carrier status for the IL-1B(+3954)T allele and IL-1RN(VNTR) allele 2 [IL-1RN(VNTR)*2] correlated with higher (P < 0.01) and lower (P < 0.05) log-CRP values, respectively. Among the potential confounding factors analysed, smoking, body mass index, total cholesterol (P < 0.05 for all) and diabetes (P = 0.056) were positively correlated with CRP level. After adjustment for non-genetic covariates, CRP levels remained significantly (P < 0.01) higher in carriers of IL-1B(+3954)T than in non-carriers: mean log-CRP (with 95% confidence interval) was 0.443 (0.311,0.574) for CT or TT genotypes compared with 0.240 (0.107,0.373) for the CC genotype, which corresponded to back-transformed CRP levels of 2.77 and 1.74 mg l,1, respectively. Adjusted association was also significant for IL-1RN(VNTR)*2 (P < 0.01), with lower CRP levels in the presence of allele 2: the mean log-CRP value was 0.252 (0.115,0.388) for carriers and 0.421 (0.290,0.552) for non-carriers (CRP 1.79 and 2.64 mg l,1, respectively). When alleles of both polymorphisms were entered into the model simultaneously, the association remained significant for IL-1B(+3954)T (P < 0.05), but not for IL-1RN(VNTR)*2. We conclude that IL-1B(+3954)T is associated with higher CRP levels in patients with CHD, and we found that this association was significant after adjustment for major risk factors. Our data also suggest a possible relationship of IL-1RN(VNTR)*2 with lower CRP levels in the same patients. [source] Impact of thrombocytosis and C-reactive protein elevation on the prognosis for patients with renal cell carcinomaINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2006KEIICHI ITO Aim: C-reactive protein (CRP) elevation is reportedly a prognostic factor in patients with renal cell carcinoma (RCC). Thrombocytosis has recently been reported also to be a prognostic factor in RCC and, like CRP, to be related to inflammatory cytokines such as interleukin-6. The aim of this study was to evaluate the importance of both thrombocytosis and CRP elevation in tumor recurrence and prognosis for patients with RCC. Methods: The clinical records of 178 patients who underwent radical nephrectomy were reviewed. Thrombocytosis was defined as a platelet count ,350 000/mm3, and CRP elevation was defined as a CRP level ,1.0 mg/dL. Disease-free survival and cause-specific survival rates were calculated. Independent predictors for recurrence and prognosis were determined. Results: Patients with thrombocytosis and patients with elevated CRP levels had significantly higher pathological T stage, clinical stage, tumor size, histological grade, and percentage of microvascular invasion than did patients without THC and patients with CRP levels <1.0 mg/dL, respectively. There was a significant correlation between platelet counts and CRP levels. Multivariate analysis showed that distant metastasis, tumor size, grade 3 components, and CRP elevation were independent predictors for prognosis but thrombocytosis was not. In N0M0 RCC patients, tumor size, microvascular invasion, and CRP elevation were independent predictors for recurrence. CRP elevation and tumor size were independent predictors for prognosis. Conclusions: Platelet count and CRP level are strongly correlated in patients with RCC, but only CRP elevation is an independent predictor for recurrence and prognosis. [source] Prednisone Prevents Inducible Atrial Flutter in the Canine Sterile Pericarditis ModelJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2008ROBERT N. GOLDSTEIN M.D. Background: Atrial fibrillation (AF) and atrial flutter (AFL) are common following cardiac surgery and are associated with significant morbidity. We tested the hypothesis that suppression of the inflammatory response with steroids would significantly modify the inducibility of postoperative AF/AFL in the canine sterile pericarditis model. Methods: Twenty-three dogs were studied daily from creation of pericarditis to the fourth postoperative day: 11 dogs were treated with oral prednisone (PRED) starting 2 days preoperatively until the end of the study; 12 dogs were controls (CON). EP testing was performed daily using epicardial electrodes placed at initial surgery. High-resolution (404 sites) epicardial mapping was performed during the terminal study. Baseline and daily CRP levels were obtained in all dogs. Results: Sustained AFL was absent in PRED (0%) versus CON dogs (91%; P < 0.001); AF induced in the early postoperative course in PRED dogs was of very short CL (mean 66 ms). Tissue inflammation was significantly attenuated in PRED dogs. Thresholds were lower in PRED versus CON dogs, significantly so on postoperative day (POD) 3. There was a trend toward lower ERPs in the PRED group at all CLs. CRP levels were markedly reduced in PRED versus CON dogs (peak CRP 78 ± 7 mg/L vs 231 ± 21 mg/L, P < 0.001), and returned to baseline in PRED dogs by POD 4, correlating with a virtual absence of sustained arrhythmia. During open chest mapping studies on POD 4, PRED dogs showed only nonsustained AF/AFL. Conclusions: Prednisone eliminated postoperative AFL, affected all EP parameters studied, and attenuated the inflammatory response associated with pericarditis. [source] Adaptation and evaluation of the Randox full-range CRP assay on the Olympus AU2700®JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 1 2007A.M. Dupuy Abstract The implementation of a high-sensitivity CRP (hs-CRP) assay as a routine laboratory parameter may be necessary. A single CRP method that could yield reliable results for the whole concentration range (0.1,200 mg/L) would be the most practical solution for the laboratory setting. The aim of this study was to assess the Randox full-range CRP assay on the Olympus AU2700® biochemistry analyzer and evaluate its analytical performance on serum and heparin plasma samples. The Randox CRP turbidimetric assay was compared with the existing CRP assay used routinely on the Olympus AU2700®. The analytical performance of the Randox CRP with both Olympus CRP reagents (CRP for normal application andhs-CRP) was good. We found that the Randox CRP method in the range of 0.5,160 mg/L was closely correlated to the Olympus CRP and hs-CRP for serum samples. According to a Bland-Altman analysis, the serum and heparinized samples showed an excellent agreement in CRP concentrations throughout the entire range (mean difference = ,0.035 ± 1.806 mg/L) as well as in CRP levels <10 mg/L. Our data indicate that Randox full-range CRP measurements using an immunoturbidimetry assay on Olympus systems perform as well for routine diagnostics as other high-sensitivity applications using serum or heparin plasma. J. Clin. Lab. Anal. 21:34,39, 2007. © 2007 Wiley-Liss, Inc. [source] Usefulness of high-sensitivity IL-6 measurement for clinical characterization of patients with coronary artery diseaseJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 3 2005Valter Lubrano Abstract Interleukin 6 (IL-6) may represent an early marker of inflammatory activation and may be useful to ameliorate risk stratification in patients with ischemic heart disease. The aim of this study was to verify the performance characteristics of an ultrasensitive immunoassay (Biosource International, Camarillo, CA) for high-sensitivity (hs)-IL-6 measurement in comparison with hs-R&D Systems (Abingdon, United Kingdom) and Immulite System (Diagnostic Products Corporation [DPC], Los Angeles, CA) methods in patients with ischemic heart disease. In addition, hs,C-reactive protein (hs-CRP) concentrations were measured, to evaluate the correlation with hs-IL-6 levels. We measured IL-6 and CRP serum levels in 39 patients with ischemic heart disease and in 12 controls. Out of the 39 patients studied, 13 were affected by unstable angina, 13 by post,acute myocardial infarction (AMI) unstable angina, and 13 by stable angina. The imprecision profile and functional sensitivity were performed measuring 9 different serum pools in 10 runs. The Biosource method had the best performance characteristics as compared to the others. Mean IL-6 level was higher in patients with unstable and post-AMI unstable angina with respect to controls. CRP levels were elevated in patients with post-AMI. In the whole population a high significant linear regression was observed between Biosource hs-IL-6 and hs-CRP serum levels. The Biosource method for IL-6 measurement is characterized by a high functional sensitivity that allows a better stratification of patients with ischemic heart disease. J. Clin. Lab. Anal. 19:110,114, 2005. © 2005 Wiley-Liss, Inc. [source] Self-reported gingivitis and tooth loss poorly predict C-reactive protein levels: a study among Finnish young adultsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2008Pekka V. Ylöstalo Abstract Objectives: Our aim in this cross-sectional study was to investigate whether self-reported gingivitis and tooth loss were associated with elevated levels of C-reactive protein (CRP) using the same study population where these dental conditions have earlier been associated with prevalent angina pectoris. Material and Methods: The study population consisted of those Northern Finland birth cohort 1966 members who lived in Northern Finland or in the Helsinki region (n=8463) at the time of the survey (1996,1997). The participation rate in a health examination was 71% (n=6033). Gingivitis and tooth loss were determined on the basis of self-reported questions. Prevalence proportion ratios (PPR) and 95% confidence intervals (CI) were estimated using multivariate regression models. Results: The results showed that self-reported gingivitis and tooth loss were weakly associated with elevated levels of CRP (>3 mg/l): adjusted PPR 1.1, CI 1.0,1.3 and PPR 1.1, CI 0.7,1.7, respectively. The proportion of variation in CRP explained by self-reported gingivitis and tooth loss was small, being <1%. Conclusion: The results suggest that self-reported gingivitis and tooth loss have a miniscule effect on CRP levels among a general population of young adults. [source] | ||||||||||||||||||||||||||||||||||