C-Reactive Protein, Inflammation and Short-Term Mortality in Acute Heart Failure
Bibliographic record
Abstract
This article refers to 'Incremental value of C-reactive protein to the MEESSI acute heart failure risk score' by D. Wussler et al., published in this issue on pages 1749-1758.C-reactive protein (CRP) was shown to be associated with heart failure (HF) more than 70 years ago (Figure 1).In a pivotal study, Elster, Braunwald and Wood 1 detected CRP in the blood of 30 of 40 patients hospitalized with HF -most of rheumatic aetiology.The presence of CRP was associated with more severe HF, as assessed by clinical signs of congestion, higher venous pressure and longer circulatory time.Four of the patients with detectable CRP, and none with non-detectable level, died.There were more recurrent pulmonary oedema events in those with detectable CRP.The authors noted that CRP levels tended to become undetectable in patients who became compensated but were persistently increased before death.CRP was not detectable in another 10 stable ambulatory patients with moderate to severe HF.The question of why CRP is elevated in patients with HF is not clearly understood.CRP is known to be produced in the liver in response to interleukin-6 stimulation 2 but it is also produced in inflammatory cells, the vasculature, and cardiac myocytes.Cardiac, hepatic, and renal dysfunction, as well as obesity, are all associated with higher CRP levels in patients with HF. 3 Since its publication in 1956, a myriad of studies have suggested associations between high CRP levels 3,4 and other inflammatory markers 5 and adverse outcomes in patients with HF.However, the association of CRP with prognosis has not been uniformly confirmed, especially when examined in the context of other biomarkers.For instance, Aimo et al. 6 have noted that although CRP was associated with more adverse outcomes in 9289 patients with stable HF, the effect was no longer statistically significant after accounting for natriuretic peptides and troponin levels.To this large body of literature, we can add the study of Wussler et al. 7 published in this issue of the Journal.In this study, the authors show that the prediction of 30-day mortality risk in patients with acute HF (AHF) is improved by the addition of CRP to the already The opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".