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C-Reactive protein as a risk factor for left ventricular thrombus in patients with acute myocardial infarction
1KTU Faculty of Medicine, Department of Cardiology, Trabzon, Turkey. ercevdet@usa.net
Insights
Elevated C-reactive protein (CRP) is a significant risk factor for left ventricular (LV) thrombus formation in patients who have experienced acute myocardial infarction (AMI). This finding highlights CRP
Area of Science:
- Cardiology
- Biochemistry
- Medical Research
Background:
- Elevated C-reactive protein (CRP) correlates with increased cardiac event risk in acute myocardial infarction (AMI) patients.
- CRP's potential role in coagulation initiation is suggested but not fully understood.
- The specific association between CRP levels and left ventricular (LV) thrombus formation in AMI patients remains uninvestigated.
Purpose of the Study:
- To determine if C-reactive protein (CRP) levels are an independent risk factor for the development of left ventricular (LV) thrombus in patients with acute myocardial infarction (AMI).
Main Methods:
- Analysis of clinical, echocardiographic, and biochemical data from 141 patients with first anterior AMI.
- Serial echocardiographic examinations (2D and Doppler) conducted on Days 1, 3, 7, 15, and 30.
- Daily blood sampling throughout hospitalization to measure serum CRP concentrations using ultrasensitive immunonephelometry.
Main Results:
- Left ventricular (LV) thrombus was identified in 23.4% of patients.
- Patients with LV thrombus exhibited higher peak creatine kinase (CK) and CRP levels.
- Multivariate analysis identified peak CK, LV apical wall motion score index, and CRP levels as independent predictors of LV thrombus formation.
Conclusions:
- C-reactive protein (CRP) is a significant independent risk factor for left ventricular (LV) thrombus formation in patients following acute myocardial infarction (AMI).
- These findings underscore the importance of monitoring CRP levels in AMI patients to assess thrombotic risk.
Background:
Elevated C-reactive protein (CRP) has been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that CRP may be involved in initiation process of coagulation; however, the role of CRP level in the formation of left ventricular (LV) thrombus has not been studied.
Hypothesis:
This study investigated whether CRP is a risk factor for LV thrombus in patients with AMI.
Methods:
Clinical, echocardiographic, and biochemical data were analyzed in 141 consecutive patients (aged 57 +/- 13 years; 33 women) with first anterior AMI. Two-dimensional and Doppler echocardiographic examinations were performed on Days 1, 3, 7, 15, and 30. Blood samples were obtained every day during hospitalization. Serum CRP concentrations were measured by an ultrasensitive immunonephelometry method.
Results:
Left ventricular thrombus was detected in 33 (23.4%) patients. Univariate analysis showed that patients with LV thrombus had a higher peak creatine kinase (CK) level (2,879 +/- 742 vs. 1,693 +/- 1,210 I/U, p = 0.001), higher peak CRP level (14.9 +/- 7.1 vs. 9.2 +/- 6.8 mg/dl, p = 0.001), higher wall motion score index (1.8 +/- 0.2 vs. 1.5 +/- 0.3, p = 0.002), higher apical wall motion score index (2.35 +/- 0.72 vs. 2.07 +/- 0.70, p = 0.001), larger end-diastolic volume (145.2 +/- 43.7 vs. 116.5 +/- 44.2 ml, p = 0.002), larger end-systolic volume (85.4 +/- 37.2 vs. 62.9 +/- 31.6 ml, p = 0.003), and lower ejection fraction (42.1 +/- 12 vs. 47.3 +/- 13, p = 0.04). In multivariate analyses, only peak CK level (p = 0.0001), LV apical wall motion score index (p = 0.001), and CRP levels (p = 0.001) were independent predictors of LV thrombus formation.
Conclusions:
These results suggest that CRP is a risk factor for LV thrombus in patients with AMI.