Comparison of High-Sensitive CRP, RDW, PLR and NLR between Patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a chronic systemic inflammation, which has similar signs and symptoms to chronic heart failure (CHF). Objective: To compare high-sensitive C-reactive protein (hsCRP) level and selected blood indices in patients with COPD and CHF. Methods: This prospective cross-sectional study (July 2019-July 2020) was conducted on patients aged 40-70 years old with a previous diagnosis of COPD, CHF, and cor pulmonale. They were divided into four groups: 1) patients with COPD, who were hospitalized due to exacerbation of dyspnea, 2) patients with CHF without a history of COPD, 3) patients with CHF and history of COPD (COPD+CHF), and finally 4) patients who had concomitant COPD and cor pulmonale condition. Spirometry, echocardiography, and six-minute walking test were performed. The hsCRP level was assessed at the beginning and end of hospital admission. Finally, RDW, neutrophil, lymphocyte, platelet counts, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were measured. Data were analyzed by SPSS software (α = 0.05). Results: In total, 140 patients were enrolled. The highest hsCRP level was observed in patients in the COPD+CHF group, and the lowest level was found in patients with CHF. Overall, a significant difference was observed in the hsCRP level at the beginning and the end of admission (P =0.0001). HsCRP had a positive correlation with the duration of hospital stay and a negative correlation with the results of the six-minute walking test. The lymphocyte counts and PLR had significant positive correlations with the six-minute walking test (R =0.38, P =0.0001 vs. R =0.325, P =0.001, respectively), and significant negative correlations with duration of hospital stay (R =-0.317, P =0.0001 vs. R =-0.380, P =0.001, respectively). At the admission, a significant difference in hsCRP was only observed comparing the COPD and cor pulmonale groups (OR =1.097, P =0.002). There were significant differences in the six-minute walking test comparing the COPD group with either of CHF or COPD+CHF groups. Significant differences were noted in the hospital stay duration comparing the COPD group with all other groups.