***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background — Data supporting the prognostic significance of high-sensitivity C-reactive protein ( hs-CRP ) are derived largely from individuals with no overt coronary artery disease or from patients with acute coronary syndromes . In contrast , the ability of hs-CRP to predict outcomes in patients with stable coronary artery disease and the prognostic significance of the Centers for Disease Control/American Heart Association hs-CRP cut points in such a population remain relatively unexplored . Methods and Results — We measured hs-CRP in 3771 patients with stable coronary artery disease from the Prevention of Events With Angiotensin-Converting Enzyme Inhibition ( PEACE ) trial , a r and omized placebo-controlled trial of the angiotensin-converting enzyme inhibitor tr and olapril . Patients were followed up for a median of 4.8 years for cardiovascular death , myocardial infa rct ion , or stroke , as well as new heart failure and diabetes . After adjustment for baseline characteristics and treatments , higher hs-CRP levels , even > 1 mg/L , were associated with a significantly greater risk of cardiovascular death , myocardial infa rct ion , or stroke ( hs-CRP 1 to 3 mg/L : adjusted hazard ratio , 1.39 ; 95 % CI , 1.06 to 1.81 ; P=0.016 ; hs-CRP > 3 mg/L : adjusted hazard ratio , 1.52 ; 95 % CI , 1.15 to 2.02 ; P=0.003 ) . Similarly , elevated hs-CRP levels were an independent predictor of new heart failure ( adjusted P<0.001 for trend ) and new diabetes ( adjusted P<0.001 for trend ) . There were no significant interactions between hs-CRP levels and the effects of tr and olapril on any of the above outcomes . Conclusions — In stable coronary artery disease , an elevated hs-CRP level , even > 1 mg/L , is a significant predictor of adverse cardiovascular events independently of baseline characteristics and treatments . An elevated hs-CRP does not appear to identify patients with stable coronary artery disease and preserved ejection fraction who derive particular benefit from angiotensin-converting enzyme inhibition BACKGROUND C-reactive protein ( CRP ) is a sensitive marker of inflammation , and elevated levels have been associated with future risk of myocardial infa rct ion ( MI ) . However , whether measurement of CRP adds to the predictive value of total cholesterol ( TC ) and HDL cholesterol ( HDL-C ) in determining risk is uncertain . METHODS AND RESULTS Among 14916 apparently healthy men participating in the Physicians ' Health Study , baseline levels of  CRP , TC , and HDL-C  were measured among 245 study subjects who subsequently developed a first MI ( cases ) and among 372 subjects who remained free of cardiovascular disease during an average follow-up period of 9 years ( controls ) . In univariate analyses , high baseline levels of CRP , TC , and TC : HDL-C ratio were each associated with significantly increased risks of future MI ( all P values < 0.001 ) . In multivariate analyses , models incorporating CRP and lipid parameters provided a significantly better method to predict risk than did models using lipids alone ( all likelihood ratio test P values < 0.003 ) . For example , relative risks of future MI among those with high levels of both CRP and TC ( RR=5.0 , P=0.0001 ) were greater than the product of the individual risks associated with isolated elevations of either CRP ( RR=1.5 ) or TC ( RR=2.3 ) . In stratified analyses , baseline CRP level was predictive of risk for those with low as well as high levels of TC and the TC : HDL-C ratio . These findings were virtually identical in analyses limited to nonsmokers and after control for other cardiovascular risk factors . CONCLUSIONS In prospect i ve data from a large cohort of apparently healthy men , baseline CRP level added to the predictive value of lipid parameters in determining risk of first MI Background Pentraxin 3 ( PTX3 ) is a novel inflammatory marker produced by various cell types including those of the vasculature and the heart . The relationship between inflammatory markers and prognosis of patients with heart failure with normal ejection fraction ( HFNEF ) remains unknown . We investigated whether plasma PTX3 levels can predict future cardiovascular events in patients with HFNEF . Methods and Results Plasma PTX3 , high‐sensitivity C‐reactive protein , and B‐type natriuretic peptide levels were measured prospect ively in 360 stable patients with HFNEF . The subsequent incidence of cardiovascular events , including cardiovascular death , nonfatal myocardial infa rct ion ( MI ) , unstable angina pectoris , nonfatal ischemic stroke , hospitalization for heart failure decompensation , and coronary revascularization , was determined . During a mean 30‐month follow‐up , 106 patients experienced cardiovascular events  . These events were more frequent in patients with high plasma PTX3 levels ( > 3.0 ng/mL ) than low levels ( ≤3.0 ng/mL ) . Multivariable Cox hazard analysis showed that PTX3 ( hazard ratio : 1.16 ; 95 % CI : 1.05 to 1.27 ; P<0.01 ) and B‐type natriuretic peptide ( hazard ratio : 1.08 ; 95 % CI : 1.03 to 1.14 ; P<0.001 ) , but not high‐sensitivity C‐reactive protein levels , were significant predictors of future cardiovascular events . Multivariable Cox analysis with the forced inclusion model , including 5 previously identified prognostic factors , found that PTX3 was a significant predictor of cardiovascular events ( hazard ratio : 1.16 ; 95 % CI : 1.06 to 1.27 ; P<0.01 ) . The C‐statistics for cardiovascular events substantially increased from 0.617 to 0.683 when PTX3 was added to the 5 previously identified prognostic factors . Conclusions High plasma PTX3 levels , but not other inflammatory markers , are correlated with future cardiovascular events in patients with HFNEF . PTX3 may be a useful biomarker for assessment of risk stratification in HFNEF . Clinical Trial Registration URL : http://www.umin.ac.jp ; Unique identifier : UMIN000002170 Sensitive cardiac troponin I ( cTnI ) predicts all-cause and cardiovascular mortality in various clinical setting s. However , its clinical significance in hemodialysis ( HD ) patients with preserved left ventricular ejection fraction ( LVEF ) has not been fully eluci date d. This study investigated the association of cTnI with LV morphology and function , and its long-term outcome in HD patients with preserved LVEF . This prospect i ve study consists of 96 HD patients with preserved LVEF ( 69 ± 8 years and 63 % male ) who underwent two-dimensional echocardiographic examination and biomarker tests including cTnI , brain natriuretic peptide , and high-sensitive C-reactive protein .  The primary endpoint was all-cause death and secondary endpoint was cardiovascular death . Factors independently associated with cTnI were systolic blood pressure ( β = − 0.239 , p = 0.011 ) , heart rate ( β = 0.216 , p = 0.021 ) , LV mass index ( β = 0.231 , p = 0.020 ) , and E to e ’ ratio ( β = 0.237 , p = 0.016 ) . During a mean follow-up of 3.6 years , primary and secondary endpoints were observed in 23 ( 24 % ) and 18 ( 19 % ) patients , respectively . In the multivariate Cox proportional hazard analysis , the upper cTnI tertile has significantly increased risk of all-cause mortality [ hazard ratio ( HR ) , 2.69 ; 95 % confidence interval ( CI ) , 1.139–6.386 ; p = 0.024 ] and that of cardiovascular death ( HR , 4.56 ; 95 % CI 2.021–16.968 ; p = 0.006 ) independent of echocardiographic measures and other serum biomarkers . In HD patients with preserved LVEF , serum cTnI levels were significantly associated with diastolic function and risk of mortality independent of echocardiographic variables and other biomarkers Aims The prognostic role of high-sensitivity C-reactive protein ( hsCRP ) in acute heart failure is less well established than for chronic heart failure and the impact of its variation is unknown . We studied the impact of hsCRP variation in acute heart failure and whether it differed according to left ventricular function . Methods We analyzed patients prospect ively included in an acute heart failure registry .  Admission and discharge hsCRP were evaluated as part of the registry 's protocol and its relative variation ( & Dgr;hsCRP ) was assessed . & Dgr;hsCRP during hospitalization = [ ( admission hsCRP – discharge hsCRP)/admission hsCRP ] × 100 . Endpoint : all-cause death ; follow-up : 3 years . A multivariate Cox-regression model was used to assess the prognostic value of & Dgr;hsCRP ( continuous and categorical variable : cut-off 40 % decrease ) ; analysis was stratified according to ventricular function . Results We studied 439 patients : mean age 75 years , 50.1 % men and 69.2 % had heart failure with reduced ejection fraction ( HFrEF ) .  Median discharge hsCRP  was 12.4 mg/l and median & Dgr;hsCRP was ∼40 % . During follow-up 247 patients ( 56.3 % ) died : 73 ( 54.1 % ) heart failure with preserved ejection fraction ( HFpEF ) patients and 174 ( 57.2 % ) HFrEF patients . The multivariate-adjusted hazard ratio of 3-year mortality in HFpEF patients with hsCRP decrease of at least 40 % during hospitalization was 0.56 ( 95 % CI 0.32–0.99 ) . A decrease of at least 40 % in hsCRP was not mortality-associated in HFrEF patients . There was interaction between & Dgr;hsCRP and left ventricular ejection fraction . Conclusion A decrease of at least 40 % in hsCRP in acute heart failure was associated with a 44 % decrease in 3-year death risk in HFpEF patients . No association between & Dgr;hsCRP and prognosis existed in HFrEF patients . Inflammation appears to play a different role according to left ventricular function BACKGROUND Soluble ST2 ( sST2 ) is a marker of inflammation and fibrosis , which is a significant predictor of prognosis of heart failure ( HF ) , independent of brain natriuretic peptide ( BNP ) . This study aim ed to clarify how sST2 associates with clinical outcome through investigations of clinical correlates and mode of death in patients with heart failure with preserved ejection fraction ( HFpEF ) . METHODS A total 191 patients with acute decompensated HF and EF ≥50 % were prospect ively enrolled .  Echocardiographic and laboratory data including sST2 were obtained in pre-discharge stable condition . RESULTS Serum sST2 level showed significant positive correlations with C-reactive protein and pentraxin3 levels , and negative correlations with body mass index , albumin , and hemoglobin . Serum sST2 level was significantly higher in patients with all-cause death and non-cardiovascular ( CV ) death compared to those without events , whereas there was no significant difference in sST2 level between patients with and without CV death . On the other h and , BNP level was significantly higher in patients with all-cause death and CV death compared to those without events . Cox regression analyses adjusted for age and sex revealed that sST2 was a significant predictor of non-CV death , whereas BNP was a significant predictor of CV death . CONCLUSIONS Serum sST2 level was associated with non-CV death showing significant correlations with systemic factors including malnutrition and inflammation , while BNP was associated with CV death 
    Output:
    
CRP can be used as a biomarker to predict the development of HFpEF and long-term clinical outcomes in HFpEF patients , in turn justifying its use as a simple , accessible parameter to guide clinical management in this patient population .