Document Detail

Admission C-reactive protein serum levels and survival in patients with acute myocardial infarction with persistent ST elevation.
MedLine Citation:
PMID:  17119378     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the prognostic value of a single and early determination of high sensitivity C-reactive protein levels at admittance in patients with acute myocardial infarction with persistent ST elevation. PATIENTS AND METHODS: We evaluated high-sensitivity C-reactive protein levels in 247 consecutive acute myocardial infarction with persistent ST elevation patients at admittance. Patients were monitored for the occurrence of major adverse cardiovascular events. RESULTS: Mean follow-up was 26 months. High C-reactive protein levels were principally associated with age > or = 65 years (P=0.01), diabetes (P=0.03) and reduced left ventricle ejection fraction (P=0.048). We observed a significant C-reactive protein level difference between the major adverse cardiovascular event-free group and the major adverse cardiovascular event group (28.2+/-21.9 vs. 47.7+/-31.9 mg/l, P=0.03), between deceased patients group (vs. 81.5+/-51.8 mg/l, P<0.001) and early deaths (vs. 129.5+/-71.9 mg/l, P<0.001). Kaplan-Meier plots for survival and major adverse cardiovascular event occurrence showed a significant separation (P=0.01 and 0.002 by log-rank test, respectively) between high and low C-reactive protein level groups. C-reactive protein levels were independent risk predictors of major adverse cardiovascular events (odds ratio 2.931, 95% confidence interval 1.512-5.893; P=0.046) and death (odds ratio 5.068, 95% confidence interval 2.056-20.195; P=0.04). Patients with high C-reactive protein levels and age > or = 65 years were at highest risk for major adverse cardiovascular event occurrence (odds ratio 5.658, 95% confidence interval 2.898-6.249; P=0.022) and death (odds ratio 8.120, 95% confidence interval 5.656-22.729; P=0.03). CONCLUSIONS: High C-reactive protein levels identify patients with a worse prognosis after acute myocardial infarction with persistent ST elevation. The evaluation of C-reactive protein and age may provide a tool to select high-risk patients.
Maria L Canale; Stefano Stroppa; Paolo Caravelli; Anna S Petronio; Rita Mariotti; Mario Mariani; Alberto Balbarini; Antonio Barsotti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  17     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-22     Completed Date:  2007-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  693-8     Citation Subset:  IM    
Division of Cardiology, Cardio-Thoracic Department, Cisanello Hospital, University of Pisa, Pisa, Italy.
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MeSH Terms
Biological Markers / blood
C-Reactive Protein / metabolism*
Follow-Up Studies
Italy / epidemiology
Middle Aged
Myocardial Infarction* / blood,  mortality,  physiopathology
Nephelometry and Turbidimetry
Patient Admission*
Retrospective Studies
Risk Factors
Survival Rate / trends
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein

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