Minami Y, et al. - In patients hospitalized for acute heart failure (AHF), researchers examined the association of C-reactive protein (CRP) level at discharge [ie, after stabilization of AHF] with subsequent post-discharge outcome. Unique long-term prognostic implications of a modestly elevated CRP level (approximately 3-10 mg/L) at discharge were suggested.

• Prospective registration of a total of 4269 hospitalized AHF patients was carried out in the ATTEND study.
• Data was obtained on CRP levels at discharge.

• The median CRP level was 3.1 mg/L (interquartile range 1.1-9.5 mg/L).
• Researchers found that within 120 days post- discharge, only CRP levels in the fourth quartile (≥9.6 mg/L) were independently associated with higher all-cause mortality (adjusted hazard ratio [HR], 1.68) according to multivariable models with first-quartile (≤1.1 mg/L) as the reference.
• They also noted that the HR for CRP levels in the fourth quartile decreased markedly with time, and there was an independent association of CRP levels in the second (1.2-3.1 mg/L) and third (3.2-9.5 mg/L) quartiles with poorer survival after the 120-day follow-up period (adjusted HR, 1.41 and 1.63, respectively).
• Additionally, after the 120 days of long-term follow-up (adjusted HR, 1.31), only CRP levels in the third quartile were found to be independently related to the composite endpoint of all-cause death and readmission for AHF.