Prognostic and diagnostic significance of serum high-sensitivity C-reactive protein level in patients with acute idiopathic pericarditis

Aviv Mager*, Yoav Hammer, Hadas Ofek, Liana Kedmi, Zaza Lakobishvili, Ran Kornowski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The frequency of increased high-sensitivity C-reactive protein (hs-CRP) and the time course of evolution of their levels in patients with acute idiopathic pericarditis (AIP) are not well established. Objective: To assess the time course of evolution of hs-CRP levels and the possible clinical significance of maximal hs-CRP levels in patients with AIP Methods: We retrospectively reviewed the medical files of 241 patients admitted to the hospital with a diagnosis of AIP between March 2006 and March 2017. Data on demographics, time of symptom onset, laboratory and imaging findings, and outcome were collected. Results: Data on serum hs-CRP levels were available for 225 patients (age 18-89 years, 181 men). Fever, pleural effusion, and age were independently associated with hs-CRP levels. Major cardiac complications (MCC) (death, cardiac tamponade, cardiogenic shock, large pericardial effusion, ventricular tachycardia, pericardiocentesis, or pericardiectomy) were more common in patients with hs-CRP levels above the median compared to those below (21.2% vs. 4.5%, respectively, P < 0.001). Hs-CRP levels were independently associated with MCC (odds ratio [OR] 1.071, 95% confidence interval [95%CI] 1.016-1.130, P = 0.011). Hs-CRP levels were elevated in 76.0%, 92.3% and 96.0% of the patients tested < 6 hours, 7-12 hours, and > 12 hours of symptom onset, respectively (P = 0.003). The frequency of elevated hs-CRP among patients tested > 24 hours was 98.1%. Conclusions: Hs-CRP levels rise rapidly among patients with AIP. Maximal hs-CRP levels are associated with MCC. A normal hs-CRP level is rare among patients tested > 24 hours of symptom onset.

Original languageEnglish
Pages (from-to)747-751
Number of pages5
JournalIsrael Medical Association Journal
Volume21
Issue number11
StatePublished - 2019

Keywords

  • Acute idiopathic pericarditis
  • C-reactive protein (CRP)
  • Outcome
  • Pericardial effusion

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