CLINICAL STUDY
C-reactive protein is increased in patients with degenerative aortic valvular stenosis
Alberto Galante, MD*  ,
Antonio Pietroiusti, MD*,
Marina Vellini, MD*,
Paola Piccolo, MD*,
Gianfederico Possati, MD ,
Michele De Bonis, MD,
Rita L. Grillo, BSc ,
Carla Fontana, MD|| and
Cartesio Favalli, MD||
* Medical Semiology and Methodology, Tor Vergata University, Rome, Italy
Clinica San Raffaele, Velletri, Italy
Department of Cardiac Surgery, Rome, Italy
Institute of Microbiology, Catholic University of the "Sacred Heart," Rome, Italy
|| Department of Experimental Medicine and Biochemical Sciences, Tor Vergata University, Rome, Italy
Manuscript received January 30, 2001;
revised manuscript received May 29, 2001,
accepted June 15, 2001.
Reprint requests and correspondence: Dr. Alberto Galante, Dipartimento di Medicina Interna, Università Tor Vergata, Via di Tor Vergata 135, 00133 Rome, Italy
galante{at}med.uniroma2.it
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 U test). Seroprevalence of H. pylori was 68.7% in patients and 79.7% in controls (p = NS), whereas seroprevalence of C. pneumoniae infection 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. pneumoniae infection (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. pneumoniae or H. pylori infection.
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Abbreviations and Acronyms
| | BMI | = body mass index | | CI | = confidence interval | | CRP | = C-reactive protein | | OR | = odds ratio |
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