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Published on: May 28, 2019
The influence of thrombolytic therapy on C-reactive protein in ST-segment elevation acute myocardial infarction
Alexandros K Tsakiris1, Panagiotis G Marnelos, Nearchos S Nearchou
11st Cardiology Department, Hellenic Red Cross Hospital-Korgialeneio-Benakeio, Athens, Greece.
Insights
Thrombolytic therapy in ST-elevation myocardial infarction (STEMI) patients is linked to lower C-reactive protein (CRP) levels. This inflammatory marker, CRP, correlates with cardiac damage and blood flow, highlighting its prognostic value.
Area of Science:
- Cardiology
- Biochemistry
- Inflammation Research
Background:
- Inflammation is central to atherosclerosis and acute coronary syndromes (ACS).
- Elevated C-reactive protein (CRP) serum levels during ACS indicate prognostic value.
- The study investigates CRP in ST-elevation myocardial infarction (STEMI) and thrombolysis effects.
Purpose of the Study:
- To assess the relationship between CRP levels and cardiac markers in STEMI patients.
- To evaluate the impact of intravenous thrombolysis on serial CRP measurements.
- To explore CRP's correlation with disease severity and blood flow post-treatment.
Main Methods:
- 36 STEMI patients were studied; 28 received successful thrombolysis.
- Serum CRP, troponin I, CK, CK-isoenzyme, and LDH were measured on admission, and at 24 and 48 hours.
- Coronary angiography assessed disease severity and culprit vessel flow.
Main Results:
- Thrombolysed patients showed significantly lower CRP levels at all time points compared to non-thrombolysed patients.
- Admission CRP levels positively correlated with cardiac myocyte necrosis markers.
- Admission CRP levels negatively correlated with TIMI flow, indicating poorer flow with higher CRP.
Conclusions:
- Thrombolytic therapy in STEMI patients is associated with a blunted CRP response in the initial 48 hours.
- CRP's strong correlation with cardiac enzymes and troponin I reinforces its value as an inflammatory marker.
- Findings suggest further research into CRP's role in STEMI management and prognosis.
Background:
Inflammation plays a crucial role in atherosclerotic processes and in acute coronary syndromes (ACS). Strong evidence of this is the elevation of C-reactive protein (CRP) serum levels during an ACS and its short- and long-term prognostic potency. The present study aimed to assess the relation between CRP serum levels and the elevation of cardiac markers in patients with ST elevation acute myocardial infarction (STEMI) as well as the effect of intravenous thrombolysis on a time series of CRP values.
Methods:
Thirty-six patients with STEMI were enrolled in the study. Twenty-eight of them received intravenous thrombolysis successfully and 8 did not receive thrombolysis. We measured serum concentrations of CRP, troponin I, creatine kinase, creatine kinase isoenzyme and lactate dehydrogenase in all patients on admission, 24 and 48 hours later. CRP serum values were obtained using the turbidimetric method. Coronary angiography was performed in all patients to estimate disease severity and culprit vessel flow after treatment.
Results:
Patients who were thrombolysed had lower CRP values on admission (p < 0.05), at 24 hours (p < 0.001) and 48 hours later (p < 0.05), compared to those without thrombolysis. CRP values on admission had a positive correlation with markers of cardiac myocyte necrosis and a negative correlation with TIMI flow.
Conclusion:
Thrombolytic therapy in patients with STEMI is associated with a less pronounced response of CRP during the first 48 hours. The close relation of CRP with cardiac enzymes and troponin I on admission adds to the proven value of this inflammatory marker and suggests directions for further research.
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