High-Sensitivity C-Reactive Protein as a Predictor of Cardiovascular Events after ST-Elevation Myocardial Infarction

Abstract

BackgroundThe association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.ObjectiveTo investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.MethodsThis prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.ResultsThe mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.ConclusionAlthough high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.

Increased complements and high-sensitivity C-reactive protein predict heart failure in acute myocardial infarction

“…In addition, increased complement proteins may impair regenerative processes to further aggravate myocardium injury (21). In uncomplicated myocardial infarction, the acute inflammatory reaction begins 4-8 h after onset, with the invasion of neutrophils from the perfused surrounding tissue, peaks within 3-4 days and returns to normal within 7 days (22). Therefore, peak complement and hs-CRP levels in patients with heart failure may be induced by ischemic necrosis and reperfusion injury may initiate this potent inflammatory stimulus (23).…”

Association Between Acute Inflammatory Response and Infarct Size in Stemi Patients Undergoing Primary PCI

“…10,11 A recent clinical study demonstrated that high-sensitivity CRP (hs-CRP) is an independent predictor for mortality at 30 days after ST-elevation myocardial infarction (STEMI). 12 The evaluation of LV function is one of the most important follow-up procedures in post-MI patients, with substantial prognostic value. Cardiac magnetic resonance (CMR) imaging is a noninvasive imaging method, which allows accurate functional and volumetric assessment of LV function with high reproducibility compared to transthoracic echocardiography.…”

Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review

“…-Eight studies identified as Cohort (including two identified as a retrospective cohort and five identified as a prospective cohort) [20][21][22][23][24][25][26][27].…”