Plasma CRP level predicts left ventricular function and exercise capacity in patients with acute myocardial...

C-reactive protein estimation can help in predicting short- and long-term prognosis after acute myocardial infarction. High plasma C-reactive protein level in the acute phase strongly indicates a poor clinical outcome of the patients with myocardial infarction.

One hundred consecutive patients admitted with ST elevation myocardial infarction in the intensive coronary care unit in our hospital who were able to do symptom-limited treadmill test during early recovery phase were studied. Plasma C-reactive protein was measured at the time of admission by immunoturbidity method. The normal value of the C-reactive protein was taken as 0.8 mg/dl. Echocardiographic study was done on day three of admission and ejection fraction was estimated by modified Simpson's method. Symptom-limited treadmill exercise test was done in all the patients. Patients were classified into two groups based on level of C-reactive protein: those with low C-reactive protein level (1.26 +/- 0.91 mg/dl, n=40) and those with high C-reactive protein level (6.52 +/- 3.97 mg/dl, n=60). Ejection fraction was lower in high C-reactive protein group (46.7 +/- 11.9%) compared to low C-reactive protein group (56.9 +/- 7.7%) (p = 0.011). Exercise capacity was lower in high C-reactive protein group (2.8 +/- 1.4 METs) compared to low C-reactive protein group (5.5 +/- 2.5 METs) p = 0.027).

C-reactive protein levels are an index of the severity of myocardial necrosis which translate to worse left ventricular function. Higher the C-reactive protein level, lower the ejection fraction and worse may be the prognosis.