High-sensitivity C-reactive protein as a prognostic marker in patients undergoing valve surgery

Introduction
An inflammatory reaction is a local or systemic response of the organs or tissues of the body to many damaging factors. One of the exponents of the inflammatory process is C-reactive protein (CRP).

Aim
To investigate the prognostic value of C-reactive protein (CRP) in patients undergoing valve surgery.

Material and methods
A prospective study was conducted on a group of consecutive patients with haemodynamically significant valve defects who underwent elective valve repair or replacement surgery. The primary end-point was in-hospital death from all causes. Patients were followed by direct observation during hospitalization. The risk of surgery using Euro-SCORE II was calculated for each patient. The plasma levels of C-reactive protein were measured by the Cardiac C-Reactive Protein (Latex) High Sensitive Test (Roche, Germany).

Results
The study group included 562 patients. The mean age in the studied population was 63 (standard deviation (SD) ±12). The mean plasma preoperative CRP level was 0.39 ±0.3 mg/dl. The primary endpoint occurred in 25 patients. At multivariate analysis age (p = 0.01), CRP (p = 0.02) and NT-proBNP (p = 0.03) remained independent predictors of the primary endpoint. A significant correlation was found between the level of CRP and haemoglobin (r = –0.3; p < 0.0001), red cell distribution width (r = 0.22; p < 0.0001), ejection fraction (r = –0.24, p = 0.007), troponin T (r = 0.3; p < 0.0001), creatinine (r = 0.26; p = 0.001) and body mass index (r = –0.29; p = 0.005). The average total time of hospitalization after the operation in patients with occurrence of the primary endpoint was 25 ±13 days.

Conclusions
Elevated preoperative CRP was associated with a poorer outcome following valve surgery.