Clinical study
C-reactive protein is increased in patients with degenerative aortic valvular stenosis

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Abstract

OBJECTIVES

The goal of this study was to assess the presence of systemic inflammation in degenerative aortic valvular stenosis.

BACKGROUND

Local inflammatory changes, resembling those observed in atherosclerosis, have been recently reported in degenerative aortic valvular stenosis. It is presently unknown whether systemic signs of inflammation, similar to those observed in atherosclerosis, may be present in this disorder.

METHODS

C-reactive protein (CRP) was measured by enzyme immunoassay in 141 subjects: 62 with trileaflet degenerative valvular aortic stenosis and 79 volunteers with similar demographic and clinical characteristics. IgG antibodies against Helicobacter pylori(enzyme-linked immunosorbant assay) and Chlamydia pneumoniae(microimmunofluorescence assay) were also measured.

RESULTS

C-reactive protein levels (mg/dl, mean ± SD) were 0.848 ± 1.42 in patients and 0.394 ± 0.50 in controls (p = 0.0001, Mann-Whitney Utest). Seroprevalence of H. pyloriwas 68.7% in patients and 79.7% in controls (p = NS), whereas seroprevalence of C. pneumoniaeinfection was higher in patients than it was in controls (59.7% vs. 33%, p = 0.003; chi-square test). After adjustment for various covariates in multiple logistic regression, the odds ratio for degenerative aortic stenosis was 3.41 for C. pneumoniaeinfection (95% confidence intervals [CI]: 1.60 to 7.30) and 2.76 for CRP (95% CI: 1.08 to 7.05). There was no significant difference in patients or controls in CRP levels according to the serostatus for C. pneumoniae.

CONCLUSIONS

Systemic signs of inflammation, similar to those found in atherosclerosis, are present in patients with degenerative aortic valve stenosis. They do not seem to be linked to C. pneumoniaeor H. pyloriinfection.

Abbreviations

BMI
body mass index
CI
confidence interval
CRP
C-reactive protein
OR
odds ratio

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Supported, in part, by a grant of Ministero dell’Università e Ricerca Scientifica-Programma di ricerca scientifica di interesse nazionale—anno 1999–2002.