НУЖНО ЛИ ОПРЕДЕЛЯТЬ ВЫСОКОЧУВСТВИТЕЛЬНЫЙ С-РЕАКТИВНЫЙ БЕЛОК У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ: КЛИНИЧЕСКИЕ И ПРОГНОСТИЧЕСКИЕ АСПЕКТЫ

Abstract

Abstract. Introduction. High-sensitivity C-reactive protein is an established marker of systemic inflammation and is associated with the severity and outcomes of chronic heart failure. Aim. The aim of the work is to evaluate the clinical characteristics and long-term 5-year prognosis in patients with chronic heart failure of ischemic origin in relation to the level of high-sensitivity C-reactive protein. Material and methods. The study included 296 patients of both sexes with stable chronic heart failure of ischemic origin. We analyzed the clinical characteristics and the risk of events within 5 years in patients with chronic heart failure with different levels of high-sensitivity C-reactive protein. Results and discussion. The median concentration of high- sensitivity C-reactive protein in patients with chronic heart failure of ischemic origin was 3.21 [1.48; 7.59] mg/l. In 52.1% of patients with chronic heart failure, the level of high-sensitivity C-reactive protein exceeded 3 mg/l, in 31% of patients, high- sensitivity C-reactive protein was in the range of 1-3 mg/l, in 16.9% of patients, the level of high-sensitivity C-reactive protein did not exceed 1 mg/l. Patients with chronic heart failure who had previously had a cerebral stroke had higher levels of high- sensitivity C-reactive protein in patients with chronic heart failure only (5.88 [2.69; 8.94] mg/l and 3.1 [1.31; 7.15] mg/l, p=0.018). Correlations were found between high-sensitivity C-reactive protein values and body mass index (rs=0.181, p=0.005), quality of ife in patients with chronic heart failure (rs=0.159, p=0.019), glucose levels (rs=0.143, p=0.028), creatinine (rs=0.153, p=0.019), uric acid (rs= 0.188, p=0.008), hemoglobin (rs= - 0.148, p=0.022). According to the ROC analysis, the value of hs CRP 3.59 mg/l can be considered as a marker of death in patients with chronic heart failure (sensitivity - 61.8%, specificity - 56.7%). An analysis of the outcomes of patients with chronic heart failure over 5 years demonstrates a greater risk of death in patients with chronic heart failure with high-sensitivity C-reactive protein more than 3 mg/l, compared with patients with high-sensitivity C-reactive protein less than 3 mg/l (OR = 2.86, CI 1.164- 7.038) and with patients with levels less than 1 mg/l was (OR=0.18, CI 0.05-0.74).