Serum C-reactive protein elevation predicts poor clinical outcome in patients with distal type acute aortic dissection: Association with the occurrence of oxygenation impairment

Yasuo Sugano, Toshihisa Anzai, Tsutomu Yoshikawa, Toru Satoh, Shiro Iwanaga, Takeharu Hayashi, Yuichiro Maekawa, Hideyuki Shimizu, Ryohei Yozu, Satoshi Ogawa

Research output: Contribution to journalArticle

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Abstract

Background: Acute aortic dissection (AAD) is sometimes complicated by respiratory failure due to severe lung oxygenation impairment. Systemic activation of inflammatory system after aortic injury may play some roles in the development of this complication. The aim of this study was to determine the significance of serum C-reactive protein (CRP) elevation in the development of oxygenation impairment and clinical outcome with distal type AAD. Methods and results: A total of 61 patients, who were admitted with distal type AAD within 24 h from the onset, were examined. Serum CRP levels, white blood cell (WBC) counts and body temperature were measured serially for at least 4 days. Oxygenation impairment, defined as the lowest PaO2/FIO2 ratio ≤200 mmHg, was noted in 31 patients (51%). In patients with oxygenation impairment, peak CRP levels (20.7±7.9 vs. 12.7±3.8 mg/dl, P<0.001), peak WBC counts (14,600±3600 vs. 11,800±4300/mm 3, P=0.008) and body temperature (38.4±0.5 vs. 38.0±0.6 °C, P=0.004) were significantly higher than those without. Peak CRP level was inversely correlated with the lowest PaO2/FIO2 (P<0.001). Patients who underwent urgent surgical treatment and/or died in the hospital had higher peak CRP levels (25.1±12.3 vs. 16.1±7.4 mg/dl, P=0.010) than those who did not. Multivariate analysis revealed that a peak CRP level ≥15 mg/dl (relative risk=12.6, P<0.001) was an independent determinant of the development of oxygenation impairment. Conclusion: The greater serum CRP elevation after distal type AAD was associated with a higher incidence of oxygenation impairment and poor clinical outcome. Systemic activation of the inflammatory system after aortic injury may play an important role in the development of oxygenation impairment.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalInternational Journal of Cardiology
Volume102
Issue number1
DOIs
Publication statusPublished - 2005 Jun 22

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C-Reactive Protein
Dissection
Blood Proteins
Body Temperature
Leukocyte Count
Wounds and Injuries
Respiratory Insufficiency
Multivariate Analysis
Lung
Incidence

Keywords

  • Acute aortic dissection
  • C-reactive protein
  • Clinical outcome
  • Inflammation
  • Oxygenation impairment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Serum C-reactive protein elevation predicts poor clinical outcome in patients with distal type acute aortic dissection : Association with the occurrence of oxygenation impairment. / Sugano, Yasuo; Anzai, Toshihisa; Yoshikawa, Tsutomu; Satoh, Toru; Iwanaga, Shiro; Hayashi, Takeharu; Maekawa, Yuichiro; Shimizu, Hideyuki; Yozu, Ryohei; Ogawa, Satoshi.

In: International Journal of Cardiology, Vol. 102, No. 1, 22.06.2005, p. 39-45.

Research output: Contribution to journalArticle

Sugano, Yasuo ; Anzai, Toshihisa ; Yoshikawa, Tsutomu ; Satoh, Toru ; Iwanaga, Shiro ; Hayashi, Takeharu ; Maekawa, Yuichiro ; Shimizu, Hideyuki ; Yozu, Ryohei ; Ogawa, Satoshi. / Serum C-reactive protein elevation predicts poor clinical outcome in patients with distal type acute aortic dissection : Association with the occurrence of oxygenation impairment. In: International Journal of Cardiology. 2005 ; Vol. 102, No. 1. pp. 39-45.
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abstract = "Background: Acute aortic dissection (AAD) is sometimes complicated by respiratory failure due to severe lung oxygenation impairment. Systemic activation of inflammatory system after aortic injury may play some roles in the development of this complication. The aim of this study was to determine the significance of serum C-reactive protein (CRP) elevation in the development of oxygenation impairment and clinical outcome with distal type AAD. Methods and results: A total of 61 patients, who were admitted with distal type AAD within 24 h from the onset, were examined. Serum CRP levels, white blood cell (WBC) counts and body temperature were measured serially for at least 4 days. Oxygenation impairment, defined as the lowest PaO2/FIO2 ratio ≤200 mmHg, was noted in 31 patients (51{\%}). In patients with oxygenation impairment, peak CRP levels (20.7±7.9 vs. 12.7±3.8 mg/dl, P<0.001), peak WBC counts (14,600±3600 vs. 11,800±4300/mm 3, P=0.008) and body temperature (38.4±0.5 vs. 38.0±0.6 °C, P=0.004) were significantly higher than those without. Peak CRP level was inversely correlated with the lowest PaO2/FIO2 (P<0.001). Patients who underwent urgent surgical treatment and/or died in the hospital had higher peak CRP levels (25.1±12.3 vs. 16.1±7.4 mg/dl, P=0.010) than those who did not. Multivariate analysis revealed that a peak CRP level ≥15 mg/dl (relative risk=12.6, P<0.001) was an independent determinant of the development of oxygenation impairment. Conclusion: The greater serum CRP elevation after distal type AAD was associated with a higher incidence of oxygenation impairment and poor clinical outcome. Systemic activation of the inflammatory system after aortic injury may play an important role in the development of oxygenation impairment.",
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T1 - Serum C-reactive protein elevation predicts poor clinical outcome in patients with distal type acute aortic dissection

T2 - Association with the occurrence of oxygenation impairment

AU - Sugano, Yasuo

AU - Anzai, Toshihisa

AU - Yoshikawa, Tsutomu

AU - Satoh, Toru

AU - Iwanaga, Shiro

AU - Hayashi, Takeharu

AU - Maekawa, Yuichiro

AU - Shimizu, Hideyuki

AU - Yozu, Ryohei

AU - Ogawa, Satoshi

PY - 2005/6/22

Y1 - 2005/6/22

N2 - Background: Acute aortic dissection (AAD) is sometimes complicated by respiratory failure due to severe lung oxygenation impairment. Systemic activation of inflammatory system after aortic injury may play some roles in the development of this complication. The aim of this study was to determine the significance of serum C-reactive protein (CRP) elevation in the development of oxygenation impairment and clinical outcome with distal type AAD. Methods and results: A total of 61 patients, who were admitted with distal type AAD within 24 h from the onset, were examined. Serum CRP levels, white blood cell (WBC) counts and body temperature were measured serially for at least 4 days. Oxygenation impairment, defined as the lowest PaO2/FIO2 ratio ≤200 mmHg, was noted in 31 patients (51%). In patients with oxygenation impairment, peak CRP levels (20.7±7.9 vs. 12.7±3.8 mg/dl, P<0.001), peak WBC counts (14,600±3600 vs. 11,800±4300/mm 3, P=0.008) and body temperature (38.4±0.5 vs. 38.0±0.6 °C, P=0.004) were significantly higher than those without. Peak CRP level was inversely correlated with the lowest PaO2/FIO2 (P<0.001). Patients who underwent urgent surgical treatment and/or died in the hospital had higher peak CRP levels (25.1±12.3 vs. 16.1±7.4 mg/dl, P=0.010) than those who did not. Multivariate analysis revealed that a peak CRP level ≥15 mg/dl (relative risk=12.6, P<0.001) was an independent determinant of the development of oxygenation impairment. Conclusion: The greater serum CRP elevation after distal type AAD was associated with a higher incidence of oxygenation impairment and poor clinical outcome. Systemic activation of the inflammatory system after aortic injury may play an important role in the development of oxygenation impairment.

AB - Background: Acute aortic dissection (AAD) is sometimes complicated by respiratory failure due to severe lung oxygenation impairment. Systemic activation of inflammatory system after aortic injury may play some roles in the development of this complication. The aim of this study was to determine the significance of serum C-reactive protein (CRP) elevation in the development of oxygenation impairment and clinical outcome with distal type AAD. Methods and results: A total of 61 patients, who were admitted with distal type AAD within 24 h from the onset, were examined. Serum CRP levels, white blood cell (WBC) counts and body temperature were measured serially for at least 4 days. Oxygenation impairment, defined as the lowest PaO2/FIO2 ratio ≤200 mmHg, was noted in 31 patients (51%). In patients with oxygenation impairment, peak CRP levels (20.7±7.9 vs. 12.7±3.8 mg/dl, P<0.001), peak WBC counts (14,600±3600 vs. 11,800±4300/mm 3, P=0.008) and body temperature (38.4±0.5 vs. 38.0±0.6 °C, P=0.004) were significantly higher than those without. Peak CRP level was inversely correlated with the lowest PaO2/FIO2 (P<0.001). Patients who underwent urgent surgical treatment and/or died in the hospital had higher peak CRP levels (25.1±12.3 vs. 16.1±7.4 mg/dl, P=0.010) than those who did not. Multivariate analysis revealed that a peak CRP level ≥15 mg/dl (relative risk=12.6, P<0.001) was an independent determinant of the development of oxygenation impairment. Conclusion: The greater serum CRP elevation after distal type AAD was associated with a higher incidence of oxygenation impairment and poor clinical outcome. Systemic activation of the inflammatory system after aortic injury may play an important role in the development of oxygenation impairment.

KW - Acute aortic dissection

KW - C-reactive protein

KW - Clinical outcome

KW - Inflammation

KW - Oxygenation impairment

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