Background: The high sensitivity C-reactive protein (Hs-CRP) is a sensitive acute phase reactant. Hypoxia and asphyxia are known to increase Hs-CRP level. The impact of cyanosis in children with congenital heart disease (CHD) on Hs-CRP values is not known.
Aim of the work: to study the effect of cyanosis in children with cyanotic CHD on level of Hs-CRP compared to apparently healthy children.
Subjects and Methods: This cross-sectional case-control study included 30 children with CHD as a study group (13 cyanotic and 17 acyanotic) and 30 healthy age and sex matched children as a control group. The study was conducted at the Pediatric Cardiology Clinic, Cairo University Children Hospital, Cairo University Hospitals. All underwent measurement of Hs-CRP using immunoassay technique on COBAS 6000.
Results: The mean ± SD age of the included children with CHD and control group was 29.37±37.52 months and 32.60±29.98 months (p=0.097). Females and males comprised 14 (46.7%) and 16(53.3%) of the CHD group and 16 (53.3%) %) and 14 (46.7%) of the control group (p=0.870). The mean ± SD age of acyanotic CHD and oxygen saturation (SpO2) were 55.82 ± 37.51 months and 98.76 ± 0.83% compared to 66.38 ±42.55 months and 87.92 ± 3.76% of the cyanotic CHD (p=0.09), (p=0.51) and (p=0.02) respectively. The mean ± SD Hs-CRP among those with cyanotic, acyanotic and control group was 1.72±3.2, 1.38±2.03 and 0.73±0.41 respectively (p=0.225). The level of Hs-CRP did not correlate with age, birth weight, heart rate, respiratory rate, SpO₂, weight percentile, height percentile, hemoglobin level, total leucocytic level, pulmonary artery pressure, ejection fraction (EF), or fractional shortening (FS).
Conclusion: Hs-CRP level is not influenced by the underlying CHD whether cyanotic or acyanotic. Hs-CRP diagnostic value is not confounded by cyanosis or SpO₂ in children with CHD. The Hs-CRP normal values for healthy children applies to those with CHD whether cyanotic or acyanotic.