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C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

2017; European Respiratory Society; Volume: 26; Issue: 143 Linguagem: Inglês

10.1183/16000617.0070-2016

1600-0617

Giovanni Leuzzi, Carlotta Galeone, Francesca Taverna, Paola Suatoni, Daniele Morelli, Ugo Pastorino,

Delphi Technique in Research

The prognostic role of baseline C-reactive protein (CRP) in chronic obstructive pulmonary disease (COPD) is controversial. In order to clarify this issue, we performed a systematic review and meta-analysis to assess the predictive effect of baseline CRP level in COPD patients. 15 eligible articles focusing on late mortality in COPD were included in our study. We performed a random-effects meta-analysis, and assessed heterogeneity and publication bias. We pooled hazard ratio (HR) estimates and their 95% confidence intervals on mortality for the comparison between the study-specific highest category of CRP level versus the lowest category. In overall analysis, elevated baseline CRP levels were significantly associated with higher mortality (HR 1.53, 95% CI 1.32–1.77, I 2 =68.7%, p<0.001). Similar results were observed across subgroups. However, higher mortality risk was reported in studies using a cut-off value of 3 mg·L −1 (HR 1.61, 95% CI 1.12–2.30) and in those enrolling an Asiatic population (HR 3.51, 95% CI 1.69–7.31). Our analysis indicates that baseline high CRP level is significantly associated with higher late mortality in patients with COPD. Further prospective controlled studies are needed to confirm these data.