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

摘要

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 1.32xe2x80x931.77; I2=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 3xe2x80x85mgxc2xb7Lxe2x88x921 (HR 1.61; 95% CI 1.12xe2x80x932.30) and in those enrolling an Asiatic population (HR 3.51; 95% CI 1.69xe2x80x937.31). 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.