Tuberc Respir Dis.  2008 Feb;64(2):125-132.

Elevated C-reactive Protein Levels are a Sign of Pulmonary Arterial Hypertension in AECOPD

• Kim SR
• Choe YH
• Lee KY
• Min KH
• Park SJ
• Lee HB
• Lee YC
• Rhee YK

Abstract

BACKGROUND: In chronic obstructive pulmonary disease (COPD) patients, the serum levels of C-reactive protein (CRP) are elevated and an increase of CRP is more exaggerated in the acute exacerbation form of COPD (AECOPD) than in stable COPD. Pulmonary arterial hypertension is a common complication of COPD. An increased level of CRP is known to be associated with the risk of systemic cardio-vascular disorders. However, few findings are available on the potential role of CRP in pulmonary arterial hypertension due to COPD.
METHODS
This study was performed prospectively and the study population was composed of 72 patients that were hospitalized due to AECOPD. After receiving acute management for AECOPD, serum CRP levels were evaluated, arterial oxygen pressure (PaO2), was measured, and the existence of pulmonary arterial hypertension under room air inhalation was determined in the patients.
RESULTS
The number of patients with pulmonary arterial hypertension was 47 (65.3%)., There was an increased prevalence of pulmonary arterial hypertension and an increase of serum CRP levels in patients with the higher stages of COPD (e.g., patients with stage 3 and stage 4 disease; P<0.05). The mean serum CRP levels of patients with pulmonary arterial hypertension and without pulmonary arterial hypertension were 37.6+/-7.4 mg/L and 19.9 +/-6.6 mg/L, respectively (P<0.05). However, there was no significant difference of the mean values of PaO2 between patients with pulmonary arterial hypertension and without pulmonary arterial hypertension statistically (77.8+/-3.6 mmHg versus 87.2+/-6.0 mmHg).
CONCLUSION
We conclude that higher serum levels of CRP can be a sign for pulmonary arterial hypertension in AECOPD patients.

Keyword

Pulmonary arterial hypertension; C-reactive protein; COPD; Exacerbation

MeSH Terms

C-Reactive Protein
Humans
Hypertension
Hypertension, Pulmonary
Inhalation
Oxygen
Prevalence
Prospective Studies
Pulmonary Disease, Chronic Obstructive
C-Reactive Protein
Hypertension, Pulmonary
Oxygen

Figure

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  Figure 1 The prevalence of pulmonary arterial hypertension according to the increases of the serum CRP levels. The prevalence of pulmonary arterial hypertension was increased in the patients with higher serum CRP levels. Low: CRP<1 mg/L; Moderate: 1 mg/L≤CRP<3 mg/L; High: CRP≥3 mg/L; PAH: pulmonary arterial hypertension.

• 

  Figure 2 The mean values of serum CRP in the COPD patients with pulmonary arterial hypertension (PAH+) or without pulmonary arterial hypertension (PAH-). The serum CRP levels of PAH+ were significantly higher than those of PAH-. Bars represent mean±SEM.

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  Figure 3 The mean values of PaO2 in the COPD patients with pulmonary arterial hypertension (PAH+) or without pulmonary arterial hypertension (PAH-). There was no significant difference of PaO2 between two groups. Bars represent mean±SEM.

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