Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated
Paolo Ortolani1, Antonio Marzocchi, Cinzia Marrozzini
1Institute of Cardiology, Azienda Ospedaliera S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna 40138, Italy. paortol@tin.it
Insights
High sensitivity C-reactive protein levels measured on admission can predict long-term survival in ST-elevation myocardial infarction (STEMI) patients. Elevated hs-C-reactive protein indicates a higher risk of mortality and adverse events after primary PCI.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Research
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Accurate risk stratification is essential for managing STEMI patients post-primary percutaneous coronary intervention (PCI).
- High-sensitivity C-reactive protein (hs-C-reactive protein) is an inflammatory marker with potential prognostic value.
Purpose of the Study:
- To assess the predictive capability of admission hs-C-reactive protein levels for long-term survival in STEMI patients undergoing primary PCI.
- To determine if hs-C-reactive protein levels can aid in stratifying risk for adverse outcomes.
Main Methods:
- Retrospective analysis of 758 STEMI patients treated with primary PCI.
- Patients categorized into four groups based on admission hs-C-reactive protein quartiles.
- Long-term follow-up to assess survival, myocardial infarction-free survival, and event-free survival.
- Multivariable analysis to identify independent predictors of outcomes.
Main Results:
- Patients in the highest hs-C-reactive protein quartile (IV) exhibited higher in-hospital mortality and cumulative adverse events.
- The IV quartile group demonstrated significantly lower long-term survival, myocardial infarction-free survival, and event-free survival.
- Admission hs-C-reactive protein was an independent predictor of long-term mortality, re-infarction, and adverse events (P < 0.05).
Conclusions:
- Admission hs-C-reactive protein levels provide reliable risk stratification for STEMI patients treated with primary PCI.
- hs-C-reactive protein serves as a valuable prognostic biomarker for predicting long-term outcomes in this patient population.
Aims:
To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI.
Methods And Results:
We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with STEMI onset <12 h and hs-C-reactive protein determination on admission. Patients were classified into four groups [I (hs-C-reactive protein < 0.48 mg/dL), II (hs-C-reactive protein > or = 0.48 to <1.2 mg/dL), III (hs-C-reactive protein > or = 1.2 to <3.1 mg/dL), IV (hs-C-reactive protein > or = 3.1 mg/dL)] according to quartiles of hs-C-reactive protein serum level. The IV quartile hs-C-reactive protein group had a higher incidence of in-hospital mortality and cumulative adverse events. At a mean follow-up of 724 +/- 376 days (range 0-1393), the IV quartile hs-C-reactive protein group showed lower estimated survival, lower estimated myocardial infarction-free survival and lower estimated event-free survival. At multivariable analysis hs-C-reactive protein appeared to be an independent predictor of long-term mortality (HR: 1.04, 95% CI: 1.01-1.07, P = 0.003), long-term mortality and re-infarction (HR: 1.03, 95% CI: 1.01-1.06, P = 0.008) and adverse events (HR: 1.03, 95% CI: 1.01-1.05, P = 0.03).
Conclusion:
Evaluation of hs-C-reactive protein on admission in STEMI patients undergoing primary PCI allows reliable risk stratification of these patients.
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