C-reactive Protein is a Predictor of Mortality in ST-segment Elevation Acute Myocardial Infarction

Abstract

Background: No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes. Methods: Using cross-sectional data from the 2015-2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (>1.0 mg/L) in 14,544 Koreans aged ≥19 years who responded to the SRH survey and had hs-CRP test results. Differences in sociodemographic factors were analyzed using Pearson's chi-square test for categorical variables or the Mann-Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders. Results: The percentage of having a very poor to poor SRH was higher in the high hs-CRP level group (22.4%) than in the low hs-CRP level group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend <0.001). After adjusting for all confounders, including chronic diseases, men with a very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with a very good SRH (fully adjusted OR, 1.74; 95% con dence interval, 1.04-2.90). Signi cant correlations were absent among women. Conclusions: A poor SRH was correlated with low-grade in ammation (high hs-CRP level) among male Korean adults. The ndings could be useful for developing health improvement programs and in goal setting at a national scale. Background Self-rated health (SRH) is an index utilized worldwide to summarize how patients perceive their overall health status [1]. SRH is an independent predictor of mortality and disease morbidity, even after adjusting for demographic, sociological, and medical risk factors [2]. Despite criticisms that SRH is assessed based on a single question, it is known to be a strong predictor in both healthy and unhealthy individuals. SRH is not only a predictor of previously diagnosed disease but also a predictor of reactions associated with the progression of disease in the premorbid stage; it encapsulates recent or sporadic health issues that may be missed by one-time objective testing, and it also re ects behavioral and emotional factors [2, 3]. C-reactive protein (CRP) is produced by hepatocytes following acute tissue injury or infection. Though CRP levels are generally elevated in cases of severe in ammation, high-sensitivity CRP (hs-CRP) levels increase nonspeci cally in the event of in ammation in the body. In particular, hs-CRP is used as an indicator to assess the risk of cardiovascular disease (CVD), and several studies have suggested hs-CRP as a predictor of mortality. In assessing CVD risk, the American Heart Association (AHA) and Centers for Disease Control and Prevention (CDC) de ned hs-CRP levels of >3.0 mg/L as indicating high risk, 1.0-3.0 mg/L as indicating average risk, and <1.0 mg/L as indicating low risk...

Hyperhomocysteinemia and inflammatory biomarkers are associated with higher clinical SYNTAX score in patients with stable coronary artery disease

“…Recent study 39 involved patients with ST-elevation acute myocardial infarction (STEMI) detected higher intrahospital mortality in those with higher CRP levels on admission to hospital. Other study 40 also showed a positive correlation between CRP and recurrent coronary events in ACS patients, but our study, to the best of our knowledge, was the first conducted to establish an association between CRP levels and the severity of CAD according to CSS in patients with stable angina pectoris.…”

“…CRP has been studied in patients with unstable and stable angina pectoris 17 . Very recent study 18 found a positive association between CRP levels and intrahospital mortality in patients with ST-elevation myocardial infarction. Another important inflammatory marker, interleukin 6 (IL-6), is engaged in pathogenesis of CAD, participating in plaque formation and its' destabilization 19 .…”

Increased high sensitive C-reactive protein is associated with major adverse cardiovascular events after STEMI

“…Therefore, the study by Kalkman et al (21) suggests that inflammation may be associated with the cardiovascular prognosis in patients who have undergone the pPCI procedure and who have also developed high hsCRP levels. By examining 118 patients with STEMI, Milano et al (22) also observed that higher levels of hsCRP at hospital admission were related to intra-hospital mortality. However, Tanveer et al (23) did not show that levels of hsCRP have an effect on intra-hospital mortality.…”

Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: A cross-sectional study using data from the Korea National Health and Nutrition Examination Survey

“…Sex differences have been reported in the relationship between CRP levels and mortality [37][38][39][40], but it is unclear why a high CRP level is only associated with an increased mortality risk in men. Dong et al analyzed the middle-aged Chinese population;…”