Prognostic Impact of Admission High-Sensitivity C-Reactive Protein in Acute Myocardial Infarction Patients With and Without Diabetes Mellitus

Lucci, Claudia; Cosentino, Nicola; Genovese, Stefano; Campodonico, Jeness; Milazzo, Valentina; Metrio, Monica De; Rondinelli, Maurizio; Riggio, Daniela; Biondi, Maria Luisa; Rubino, Mara; Celentano, Katia; Bonomi, Alice; Capra, Nicolò; Veglia, Fabrizio; Agostoni, Piergiuseppe; Bartorelli, Antonio L.; Marenzi, Giancarlo

doi:10.21203/rs.3.rs-44229/v2

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…In various populations low-grade inflammation has indeed been related to a higher risk of cardiovascular events and cardiovascular mortality [15][16][17]. In acute myocardial infarction patients with and without DM, hs-CRP predicts in-hospital outcome and two-year mortality [18]. It has also been shown that lowering low-grade inflammation in patients with coronary artery disease with or without type 2 diabetes reduces the residual risk for cardiovascular events [19].…”

Section: Introductionmentioning

confidence: 99%

Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

Sharif

Graaf

Cramer

et al. 2021

Cardiovasc Diabetol

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Background Type 2 diabetes is a condition associated with a state of low-grade inflammation caused by adipose tissue dysfunction and insulin resistance. High sensitive-CRP (hs-CRP) is a marker for systemic low-grade inflammation and higher plasma levels have been associated with cardiovascular events in various populations. The aim of the current study is to evaluate the relation between hs-CRP and incident cardiovascular events and all-cause mortality in high-risk type 2 diabetes patients. Methods Prospective cohort study of 1679 type 2 diabetes patients included in the Second Manifestations of ARTerial disease (SMART). Cox proportional hazard models were used to evaluate the risk of hs-CRP on cardiovascular events (composite of myocardial infarction, stroke and vascular mortality) and all-cause mortality. Hs-CRP was log-transformed for continuous analyses. Findings were adjusted for age, sex, BMI, current smoking and alcohol use, non-HDL-cholesterol and micro-albuminuria. Results 307 new cardiovascular events and 343 deaths occurred during a median follow-up of 7.8 years (IQR 4.2–11.1). A one unit increase in log(hs-CRP) was related to an increased vascular- and all-cause mortality risk (HR 1.21, 95% CI 1.01–1.46 and HR 1.26, 95% CI 1.10–1.45 respectively). No relation was found between log(hs-CRP) and myocardial infarction or stroke. The relations were similar in patients with and without previous vascular disease. Conclusion Low grade inflammation, as measured by hs-CRP, is an independent risk factor for vascular- and all-cause mortality but not for cardiovascular events in high-risk type 2 diabetes patients. Chronic low-grade inflammation may be a treatment target to lower residual cardiovascular risk in type 2 diabetes patients.

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Section: Introductionmentioning

confidence: 99%

Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

Sharif

Graaf

Cramer

et al. 2021

Cardiovasc Diabetol

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“…59 Several other trials have confirmed this correlation. 60,61 In 2018, our research group reported that hs-CRP level is in correlation with infarct size in STEMI patients. 62…”

Section: Inflammation and Major Cardiovascular Eventsmentioning

confidence: 99%

Cardiovascular Risk Factors from Another Point of View

Oltean¹,

Kovács²,

Hodaş³

et al. 2021

Journal of Interdisciplinary Medicine

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Cardiovascular diseases remain the main cause of death in western societies. This contributes to the appearance of new diagnostic and treatment methods addressed to reduce the burden of cardiovascular diseases. In the last decades new imaging methods have emerged; furthermore, routine biomarkers were found to be useful in cardiovascular risk stratification. Data reviewed in this article emphasize the multifactorial etiology of cardiovascular disease. The authors describe the role of inflammation in the precipitation and progression of atherosclerosis and atrial fibrillation. Affordable and well-known inflammatory markers can be used alone or in combination with new imaging methods for a better cardiovascular risk stratification. Coronary computed tomographic angiography findings and inflammatory markers are capable to identify patients with high risk of major adverse cardiovascular events or atrial fibrillation. Furthermore, they also have an important role in the choice of treatment strategy and follow-up.

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“…Inflammation is one of the mechanisms leading to AMI, 4 high‐sensitivity C‐reactive protein (hs‐CRP) as a biomarker of inflammation has been proven to be an important risk factor for cardiovascular disease, 5 It has also been shown to be associated with prognosis in patients with myocardial infarction 6 . The relationship between hs‐CRP and the Grace risk score is not clear.…”

Section: Introductionmentioning

confidence: 99%

Admission high‐sensitivity C‐reactive protein levels improve the Grace risk score prediction on in‐hospital outcomes in acute myocardial infarction patients

Lin

Sun

et al. 2022

Clinical Cardiology

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Background Acute myocardial infarction (AMI) is the main cause of death and disability in cardiovascular and cerebrovascular diseases. Both the Global Registry of Acute Coronary Events (Grace) score and high‐sensitivity C‐reactive protein (hs‐CRP) were associated with prognosis in patients with AMI. However, whether the addition of the hs‐CRP to Grace risk score could improve the predictive power of Grace risk score on the prognosis of patients with AMI is unclear. Hypothesis: We hypothesized that the inclusion of hs‐CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in‐hospital outcomes. Methods We retrospectively enrolled 1804 patients with AMI in the final analysis. Patients were divided into four groups by hs‐CRP quartiles. The relation between hs‐CRP and Grace risk score was analyzed by Spearman rank correlation. Logistic regression was used to identify independent risk factors. The predictive value of hs‐CRP add to Grace risk score was evaluated by C‐statistic, net reclassification improvement (NRI), integrated differentiation improvement (IDI), calibration plot, and decision curve analysis. Results The hs‐CRP and Grace risk score had a significantly positive correlation (r = .191, p < .001). hs‐CRP combined with Grace risk score could improve the ability of Grace risk score alone to correctly redistinguish the occurrence of in‐hospital outcome (C‐statistic = 0.819, p < .001; NRI = 0.05956, p = .007; IDI = 0.0757, p < .001). Conclusion Admission hs‐CRP level was a significant independent risk factor for in‐hospital outcomes in patients with AMI. The inclusion of hs‐CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in‐hospital outcomes.

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Prognostic Impact of Admission High-Sensitivity C-Reactive Protein in Acute Myocardial Infarction Patients With and Without Diabetes Mellitus

Cited by 3 publications

References 36 publications

Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

Cardiovascular Risk Factors from Another Point of View

Admission high‐sensitivity C‐reactive protein levels improve the Grace risk score prediction on in‐hospital outcomes in acute myocardial infarction patients

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