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

Eur Respir Rev. 2017 Jan 31;26(143):160070. doi: 10.1183/16000617.0070-2016. Print 2017 Jan.


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 1.32-1.77, 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 3 mg·L-1 (HR 1.61, 95% CI 1.12-2.30) and in those enrolling an Asiatic population (HR 3.51, 95% CI 1.69-7.31). 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.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Asian Continental Ancestry Group
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism*
  • Humans
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / ethnology
  • Pulmonary Disease, Chronic Obstructive / metabolism*
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Up-Regulation


  • Biomarkers
  • C-Reactive Protein