Acute phase proteins and systolic dysfunction in subjects with acute myocardial infarction

Abstract

Systolic dysfunction in STEMI patients seems to be associated with an inflammatory response featured by a rise in plasmatic concentration of APPs; increase in APPs concentrations seems to own a short-term prognostic relevance.

Admission Levels of C-Reactive Protein and Plasminogen Activator Inhibitor-1 in Patients With Acute Myocardial Infarction With and Without Cardiogenic Shock or Heart Failure on Admission

“…28) Moreover, it has also been suggested that CRP is not only a marker of inflammation, but also an active participant and amplifier in the process of AMI. 29) On the other hand, it has also been demonstrated that high CRP levels both on admission 6) and at peak 30) are associated with the occurrence of mild to severe HF (Killip class II to IV) during the hospitalization period in AMI patients, and there are also studies in which higher admission CRP levels were observed in AMI patients who developed CS during the pre-or postadmission period. 8,9) In general, these observations are in agreement with our results.…”

“…47,48) Finally, in this study higher levels of both CRP and PAI-1 on admission were independent predictors of in-hospital and 1-year mortality in CS patients. While elevated levels of circulating CRP on admission have been rather clearly demonstrated to be an independent predictive factor for adverse outcomes both for hospital stay and longer time periods in ACS patients or specifically in AMI patients, [3][4][5][6][7] this association has been reported only for the hospital stay 10,12) and for 30-day follow-up 14) for PAI-1. However, to our knowledge, there are only two studies 8,9) addressing the relationship between CRP levels on admission and clinical outcomes and no studies addressing this issue for PAI-1 in patients with CS complicating AMI.…”

“…1) It has been demonstrated in acute myocardial infarction (AMI) patients that admission levels of plasma C-reactive protein (CRP), which is a sensitive inflammatory marker, are elevated 2,3) and associated with short-and long-term outcomes, [2][3][4][5] including the occurrence of heart failure (HF) during the hospitalization period. 6) Moreover, inflammatory processes have also been suggested to play a role in the pathogenesis of cardiogenic shock (CS) complicating AMI. 7) Accordingly, there are studies reporting high CRP levels on admission among patients with CS complicating AMI.…”

Plasma Ceruloplasmin, a Regulator of Nitric Oxide Activity, and Incident Cardiovascular Risk in Patients with CKD

“…Furthermore, we show a significant association between high Cp and poor long-term prognosis independent of traditional cardiac risk factors. Although elevated Cp is associated with cardiovascular events in other populations of healthy individuals (5-7), the setting of acute coronary syndromes (8,9), and stable cardiac patients (10), this study is the first study, to our knowledge, that examines the relationship between serum Cp and clinical outcomes in patients with CKD. It is conceivable that future studies designed to modulate Cp's cardio-and possibly even renoprotective effects will present novel therapeutic strategies in this population, which suffers from significant cardiovascular morbidity and mortality.…”

“…In vitro, Cp shows NO oxidase activity by catalytic consumption of NO, whereas Cp immunodepletion, Cp knockout mice, and humans with congenital aceruloplasminemia all show diminished plasma NO oxidase activity (4). Several studies have also connected Cp levels with increased cardiovascular risk in both the normal population (5-7) and patients with acute coronary syndromes (8,9). In particular, our group has shown the prognostic value of elevated Cp, even after adjustment for traditional risk factors, for determining the future risk of cardiac events in stable cardiac patients (10).…”