Original scientific paper
https://doi.org/10.3325/cmj.2019.60.309
Admission C-reactive protein and outcomes in acute aortic dissection: a systematic review
Mislav Vrsalović
; University of Zagreb School of Medicine, Zagreb, Croatia
Ana Vrsalović Presečki
; Faculty of Chemical Engineering and Technology, University of Zagreb, Zagreb, Croatia
Abstract
Aim To assess the prognostic role of admission C-reactive
protein (CRP) in patients with acute aortic dissection (AAD).
Methods We searched Medline and Scopus for studies
published before January 2019 that evaluated the prognostic
impact of CRP on all-cause mortality during shortand
mid-term follow-up period in patients with AAD. Additional
studies were identified by manual search of the
references from the original studies. Receiver-operating
characteristic curves were used to determine the optimal
cut-off values of admission CRP for the prediction of
mortality, and patients were categorized into two groups
based on the CRP cut-off levels.Results Medline, Scopus, and manual literature search
yielded 138 citations. Based on the title and abstract analysis
and review of potentially relevant studies, five studies,
involving 711 patients, were included in the final analysis.
Multivariate statistical analysis was performed in all the
studies. The median admission CRP value across the studies
was 13 mg/L (range 4-21 mg/L). Two out of three studies
that evaluated in-hospital outcome and all of the studies
that evaluated medium-term outcome reported a significant
association between elevated CRP values and mortality.
The studies that included treatment strategy (surgery
vs conservative treatment) as a confounding variable confirmed
a significant effect of elevated CRP values on both
in-hospital and mid-term unfavorable outcomes.
Conclusion This systematic review demonstrated a clear association
between elevated admission serum CRP levels and
increased in-hospital and mid-term mortality risk in AAD.
Keywords
Hrčak ID:
240096
URI
Publication date:
15.8.2019.
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