Document Detail

Early inflammation and risk of long-term development of heart failure and mortality in survivors of acute myocardial infarction predictive role of C-reactive protein.
MedLine Citation:
PMID:  16516078     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We aimed to study the relationship between C-reactive-protein (CRP), obtained within 12 to 24 h of symptoms onset, and long-term risk of death and heart failure (HF) in survivors of acute myocardial infarction (MI). BACKGROUND: A robust inflammatory response is an integral component of the response to tissue injury during MI. The magnitude of the early inflammatory response to ischemic injury might be an important determinant of long-term outcome. METHODS: We prospectively studied 1,044 patients admitted with acute MI and discharged from hospital in stable condition. RESULTS: During a median follow-up of 23 months (range, 6 to 42 months), 113 patients died and 112 developed HF. In a multivariable Cox regression model adjusting for clinical variables and predischarge ejection fraction, compared with patients in the first CRP quartile, the adjusted hazard ratios (HRs) for death progressively increased with higher quartiles of CRP (second quartile 1.4 [95% confidence interval (CI) 0.6 to 2.9]; third quartile 2.3 [95% CI 1.2 to 4.6]; fourth quartile 3.0 [95% CI 1.5 to 5.7]; for trend, p = 0.0002). Compared with patients in the first CRP quartile, the adjusted HRs for HF were: second quartile, 1.1 (95% CI 0.5 to 2.3); third quartile, 1.9 (95% CI 1.0 to 3.6); and fourth quartile, 2.1 (95% CI 1.2 to 3.9) (for trend, p = 0.005). CONCLUSIONS: C-reactive-protein is a marker of long-term development of HF and mortality in patients with acute MI and provides prognostic information beyond that provided by conventional risk factors and the degree of left ventricular systolic dysfunction.
Mahmoud Suleiman; Rania Khatib; Yoram Agmon; Riad Mahamid; Monther Boulos; Michael Kapeliovich; Yishai Levy; Rafael Beyar; Walter Markiewicz; Haim Hammerman; Doron Aronson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  47     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-06     Completed Date:  2006-05-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  962-8     Citation Subset:  AIM; IM    
Department of Cardiology, Rambam Medical Center and the Bruce Rappaport faculty of medicine, Haifa, Israel.
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MeSH Terms
C-Reactive Protein / analysis*
Heart Failure / etiology*,  mortality*
Inflammation / etiology*
Middle Aged
Myocardial Infarction / blood*,  complications,  mortality*
Prospective Studies
Risk Factors
Time Factors
Reg. No./Substance:
9007-41-4/C-Reactive Protein

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