C-reactive Protein (CRP) in Patients With Myocarditis: A Systematic Review and Meta-Analysis

心肌炎患者C反应蛋白(CRP)水平:系统评价和荟萃分析

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Abstract

Myocarditis is a type of cardiovascular disease related to inflammation of cardiac muscle which can be even fatal to some extent. Early and simple diagnosis is crucial for this complication; however, complex or machine-based methods, such as histological tests, x-rays, electrocardiograms, etc., are usually used for its detection. C-reactive protein (CRP) is a biomarker that naturally elevates during inflammation. Therefore, we tried to understand the correlation between CRP and myocarditis. We primarily identified 451 studies from PubMed, Google Scholar, and ScienceDirect and ultimately selected four studies as eligible. We identified the mean difference (MD) in CRP levels between the myocarditis patients and healthy controls. The study quality, outliers, sensitivity, significance, and heterogeneity were also checked. The MD (6.03 (95%CI: 2.41-9.64), p<0.00001) corresponds to a higher and significant CRP level in myocarditis as compared to the control group. The study quality was found to be high with no bias or outliers and the heterogeneity was also determined to be high (I(2)=99%). Using the fixed effect model, the forest plot determined a similar result as the main outcome (MD: 5.08 (95%CI: 4.85-5.32)) proving higher sensitivity and reproducibility. These findings indicated the possibility of CRP being an established biomarker for an accurate diagnosis and prognosis of myocarditis.

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