Evaluation of C-reactive protein as predictor of adverse prognosis in acute myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis from 18,715 individuals

Abstract

BackgroundProper prognostic biomarker is of great importance for clinical decision-making in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Although recently emerges plenty of novel inflammatory biomarkers, the canonical inflammatory mediator C-reactive protein still plays an important role in prognosing adverse post-infarction complications.MethodsPubMed, Embase, and Medline were systematically searched from the establishment of databases up to December 2021, conforming with standards set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.ResultsA total of 23 studies were eventually eligible for this meta-analysis, including 18,715 individuals. Our findings showed that elevated C-reactive protein (CRP) had a statistically significant superiority in predicting all-cause mortality (OR: 3.22, 95% CI: [2.71, 3.84], p < 0.00001), cardiovascular death (OR: 3.26, 95% CI: [2.30, 4.61], p < 0.00001), major adverse cardiovascular events (MACEs) (OR: 2.85, 95% CI [2.08, 3.90], p < 0.00001), heart failure (OR: 2.29, 95% CI: [1.48, 3.54], p = 0.0002), recurrent myocardial infarction (OR: 1.76, 95% CI: [1.28, 2.43], p < 0.001), and restenosis (OR: 1.71, 95% CI: [1.18, 2.47], p = 0.004). Subgroup analysis implies that CRP had better performance in predicting plenty of hospitalization and short-term (<12 months) adverse prognosis than long-term prognosis and Asian patients with elevated CRP were under more risk in adverse prognosis after PCI than Europeans.ConclusionOur meta-analysis suggests that CRP is a prospective predictor of the prognosis in patients with AMI undergoing PCI, especially in hospitalization and short-term and in the Asian group.

Peripheral Inflammatory Factors and Acute Myocardial Infarction Risk: A Mendelian Randomization Study

“…Previous observational studies have found many peripheral inflammatory factors and inflammatory cells associated with AMI. Liu et al reported that C-reactive protein (CRP) may be a prospective predictor of prognosis in patients with AMI undergoing percutaneous coronary intervention [ 6 ]. Several studies suggested that interleukin (IL)-1, IL-6 and IL-18 were associated with the onset of AMI, myocardial repair, the development of complications, and the readmission of patients to the hospital, whereas IL-10 may be antagonistic to IL-6 in this disease [ 7 8 9 10 ].…”

Prognostic value of a level of decrease in mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) for major adverse cardiovascular events after myocardial infarction without ST-segment elevation: an observational study

“…To improve the risk stratification of those patients, different inflammatory and hematological markers have been tested as predictive factors for MACEs after NSTEMI and STEMI. Among inflammatory markers, elevated C-reactive protein (CRP) has been proven to be the strongest independent factor in predicting overall lethal outcome, cardiac death, and MACEs in STEMI or NSTEMI patients after percutaneous coronary intervention (PCI) [ 1 ]. Platelets, as very important factors, are involved in the mechanisms of the development of cardiovascular diseases, such as atherosclerosis and ACS.…”

Appetite Predicts Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction

“…However, some patients with AMI would have adverse events including stent thrombosis, acute heart failure, and sudden cardiac death even after the development of PCI and GDMT [3,4]. Several clinical factors are reported to be related to poor long-term prognosis in patients with AMI [5][6][7]. However, predictors for long-term outcomes of AMI are still important for stratifying patients with AMI according to the future risk after discharge.…”