Document Detail

Acute-phase inflammatory markers during myocardial infarction: association with mortality and modes of death after 7 years of follow-up.
MedLine Citation:
PMID:  19834327     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The relationship between acute-phase inflammatory markers in the setting of acute myocardial infarction (AMI) and long-term outcomes is largely unexplored. OBJECTIVES: The aim of the study was to investigate the predictive power of acute-phase inflammatory markers following AMI for short-term and long-term mortality separately and modes of death. METHODS: In 220 unselected patients with AMI [median age 67 (interquartile range 60-74) years, women 26%], blood neutrophil granulocytes, erythrocyte sedimentation rate, C-reactive protein, and alpha1-acid glycoprotein were measured 1, 3 and 7 days after admission. All patients completed 7 years of follow-up. Endpoints were 1-year (short-term) and 2- to 7-year (long-term) mortality and modes of death, classified as nonsudden cardiovascular, sudden, and noncardiovascular death. RESULTS: The short-term mortality rate was 18%. The long-term mortality rate was 26%. The short-term mortality risk was higher in patients in whom the markers were in the upper tertile. Fully adjusted hazard ratios (and 95% confidence interval) were 3.2 (1.4-7.9), 3.5 (1.7-7.9), 3.5 (1.6-8.6), and 6.1 (2.3-19.1) for neutrophil granulocyte, erythrocyte sedimentation rate, C-reactive protein, and alpha1-acid glycoprotein, respectively. The excess mortality was chiefly due to nonsudden cardiovascular mortality [fully adjusted hazard ratios were 4.6 (1.7-14.7), 4.7 (1.9-13.7), 5.9 (2.0-21.3) and 5.5 (2.0-17.6), respectively], whereas no association was found with sudden death or noncardiovascular modes of death. In the long term, the association with mortality and modes of death was no longer significant. CONCLUSION: The acute-phase inflammatory markers tested following AMI are independently and concordantly associated with short-term mortality and their prediction is associated only with nonsudden cardiovascular modes of death. These markers are not associated with long-term mortality.
Giuseppe Berton; Rosa Palmieri; Rocco Cordiano; Fiorella Cavuto; Sigismondo Pianca; Paolo Palatini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2009-12-25     Completed Date:  2010-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  111-7     Citation Subset:  IM    
Department of Cardiology, Conegliano General Hospital, Conegliano, Italy.
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MeSH Terms
Biological Markers / blood
Blood Sedimentation
C-Reactive Protein / metabolism*
Italy / epidemiology
Leukocyte Count
Middle Aged
Myocardial Infarction / blood*,  mortality
Orosomucoid / metabolism*
Prospective Studies
Survival Analysis
Reg. No./Substance:
0/Biological Markers; 0/Orosomucoid; 9007-41-4/C-Reactive Protein

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