Predischarge C-Reactive Protein and 1-year Outcome After Acute Coronary Syndromes

Steg, Philippe Gabriel; Ravaud, Philippe; Tedgui, Alain; Puel, Jacques; Moyse, Dominique; Curaudeau, E.; Quentzel, Steven

doi:10.1016/j.amjmed.2006.02.018

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Consistent results from earlier studies have demonstrated a strong and independent association between CRP concentrations and cardiovascular end points, including acute coronary syndrome, stroke, and progression of peripheral arterial occlusive disease both in healthy participants [3,29] and in secondary prevention [2,8]. Increased CRP levels were also shown to predict recurrent instability in patients admitted with an acute coronary syndrome [9,10], or undergoing invasive procedures [11,12], such as percutaneous transluminal coronary angioplasty, stenting, or bypass grafting [23], and in other high-risk groups [30][31][32].…”

Section: Discussionsupporting

confidence: 77%

“…Serum C-reactive protein (CRP) is a sensitive indicator of inflammation [1] and is actually considered a new marker of increased risk of cardiovascular events [2][3][4][5][6][7][8]. Consistent results from clinical studies indicate that high CRP levels predict recurrent instability in patients with acute coronary syndrome [9,10] or undergoing coronary angioplasty [11,12], and are a strong predictor of hospital readmission in patients with heart failure [13]. Furthermore, an increase in CRP is a common finding in the acute phase reaction after a surgical trauma, and serial measurements seem to be useful for quantifying the degree of tissue damage, the invasiveness of the procedure, and the early detection of surgical complications, especially infective [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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‘Lone’ increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value

Piccoli¹,

Cerquetani²,

Pastena³

et al. 2008

European Journal of Cardiovascular Prevention & Rehabilitat

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

‘Lone’ increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value

Piccoli¹,

Cerquetani²,

Pastena³

et al. 2008

European Journal of Cardiovascular Prevention & Rehabilitat

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“…Whether the results of studies point to an association between CRP and relevant clinical endpoints 24 or oppose that hypothesis 25,27,31 , most available evidence is based on patients receiving thrombolytic drugs. The retrospective design and failure to use the high-sensitivity method for determining CRP are also important limitations 25 .…”

Section: Discussionmentioning

confidence: 99%

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

Ribeiro¹,

Ramos²,

Vieira³

et al. 2014

Arquivos Brasileiros De Cardiologia

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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.

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“…Steg and colleagues demonstrated that CRP levels before hospital discharge are a poor predictor of cardiovascular events after MI and suggest that inflammation at this time point could be confounded by PCItriggered inflammation. 67 Taken together, these data suggest that CRP holds great prognostic value and could be beneficial in patients presenting late after STEMI who have not undergone PCI. Considerable data support the ability of statins to lower CRP levels after MI, independent of effects on serum LDL cholesterol.…”

Section: C-reactive Proteinmentioning

confidence: 95%

Late medical versus interventional therapy for stable ST-segment elevation myocardial infarction

2008

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ST-segment elevation myocardial infarction (STEMI) is associated with high morbidity and mortality, but timely reperfusion is known to result in dramatically improved patient outcomes. As many as 40% of patients with STEMI, however, present late after symptom onset, which reduces the likelihood of them receiving reperfusion therapy. The past two decades have been plagued with controversy regarding the relative benefits of reperfusion therapy after 12 h from symptom onset. Despite considerable data supporting late reperfusion and the 'late open-artery hypothesis', recent studies have demonstrated a lack of benefit with late reperfusion. Moreover, advances in the medical management of STEMI have dramatically reduced morbidity and mortality, further challenging the need for more-invasive techniques. Numerous questions have arisen regarding the appropriate management and risk stratification of asymptomatic post-STEMI patients who present late after symptom onset. In light of recent data, we present a Review of late reperfusion in STEMI, specifically highlighting the effects of current medical therapies, risk-stratification techniques, and indications for the use of late reperfusion over medical management.

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Predischarge C-Reactive Protein and 1-year Outcome After Acute Coronary Syndromes

Cited by 8 publications

References 19 publications

‘Lone’ increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value

‘Lone’ increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value

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

Late medical versus interventional therapy for stable ST-segment elevation myocardial infarction

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