Elevated levels of plasma C-reactive protein are associated with decreased graft survival in cardiac transplant recipients

被引:78
作者
Eisenberg, MS [1 ]
Chen, HJ [1 ]
Warshofsky, MK [1 ]
Sciacca, RR [1 ]
Wasserman, HS [1 ]
Schwartz, A [1 ]
Rabbani, LE [1 ]
机构
[1] Columbia Univ Coll Phys & Surg, Dept Med, Div Cardiol, New York, NY 10032 USA
关键词
transplantation; inflammation; proteins; survival;
D O I
10.1161/01.CIR.102.17.2100
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Inflammation may be involved in the origin of transplant coronary artery disease, We hypothesized that plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6), markers for systemic inflammation, would correlate with cardiac transplant graft survival. Methods and Results-We studied 99 consecutive cardiac transplant recipients who were referred for routine endomyocardial biopsy and/or surveillance coronary angiography, Plasma levels of CRP and IL-6 were measured by their respective ELISAs. Patients were divided into 2 groups: those who died or required retransplantation and those who survived without the need for retransplantation. During the follow-up period of 5.0+/-2.7 years (range, 0.2 to 15.1 years) after transplant, 20 patients died and 9 required retransplantation. There was no significant difference in age, race, sex, cause of native myopathy, presence of diabetes, or use of aspirin, statins, or calcium channel blockers between the 2 groups. Although IL-6 did not relate to graft failure, CRP level was predictive of allograft failure (P=0.003). The risk of allograft failure increased 36% for every 2-fold increase in CRP level. Moreover, CRP levels also correlated significantly with the frequency of grade 3 rejection (P=0.02). In multivariate analysis, when combined with other significant predictors such as donor age and sex mismatching of the graft, CRP still significantly predicted graft failure (P=0.025) with a 32% increase in the risk of graft failure for every 2-fold increase in CRP level. Conclusions-These findings suggest that elevated plasma levels of CRP are associated with subsequent allograft failure in cardiac transplant recipients.
引用
收藏
页码:2100 / 2104
页数:5
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