Document Detail


Prognostic usefulness of serial C-reactive protein measurements in ST-elevation acute myocardial infarction.
MedLine Citation:
PMID:  23040593     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been reported that increased levels of C-reactive protein are related to adverse long-term prognosis in the setting of ST-segment elevation acute myocardial infarction (MI). In previous studies, the timing of C-reactive protein determination has varied widely. In the present study, serial high-sensitivity C-reactive protein (hsCRP) measurements were performed to investigate if any of the measurements is superior regarding long-term prognosis. A total of 861 consecutive patients admitted for ST-segment elevation MI and treated with intravenous thrombolysis within the first 6 hours from the index pain were included. HsCRP levels were determined at presentation and at 24, 48, and 72 hours. The median follow-up time was 3.5 years. New nonfatal MI and cardiac death were the study end points. By the end of follow-up, cardiac death was observed in 22.4% and nonfatal MI in 16.1% of the patients. HsCRP levels were found to be increasing during the first 72 hours. Multivariate Cox regression analysis demonstrated that hsCRP levels at presentation were an independent predictor of the 2 end points (relative risk [RR] 2.8, p = 0.002, and RR 2.1, p = 0.03, for MI and cardiac death, respectively), while hsCRP levels at 24 hours did not yield statistically significant results (RR 1.4, p = 0.40, and RR 1.1, p = 0.80, for MI and cardiac death, respectively). The corresponding RRs at 48 hours were 1.2 (p = 0.5) for MI and 3.2 (p = 0.007) for cardiac death and at 72 hours were 1.6 (p = 0.30) for MI and 3.9 (p <0.001) for cardiac death. In conclusion, hsCRP levels at presentation represent an independent predictor for fatal and nonfatal events during long-term follow-up. HsCRP levels at 48 and 72 hours, which are close to peak hsCRP levels, independently predict only cardiac death.
Authors:
Stamatis S Makrygiannis; Olga S Ampartzidou; Michael N Zairis; Nikolaos G Patsourakos; Christos Pitsavos; Dimitris Tousoulis; Athanasios A Prekates; Stefanos G Foussas; Dennis V Cokkinos
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-10-02
Journal Detail:
Title:  The American journal of cardiology     Volume:  111     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-18     Completed Date:  2013-02-14     Revised Date:  2013-04-23    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-30     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Cardiology Department, Tzanio Hospital of Piraeus, Piraeus, Greece. ssmakrygiannis@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
C-Reactive Protein / metabolism*
Cause of Death / trends
Electrocardiography*
Female
Follow-Up Studies
Greece / epidemiology
Humans
Male
Middle Aged
Myocardial Infarction / blood*,  diagnosis,  mortality
Prognosis
Retrospective Studies
Severity of Illness Index
Time Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
Am J Cardiol. 2013 Apr 1;111(7):1079-80   [PMID:  23498089 ]

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