Quantitative C reactive protein levels and acute myocardial infarction complications in a Hispanic population: an
Evelyn Rentas1, Miguel Pérez Arzola, Rafael Bredy
1Internal Medicine Residency, Damas Hospital - Ponce School of Medicine Teaching Consortium, Ponce, Puerto Rico.
Insights
Quantitative C-reactive protein (QtCRP) levels may predict acute post-myocardial infarction complications in Hispanic patients. Elevated QtCRP (≥6.07 mg/dl) is linked to adverse outcomes like heart failure and reinfarction.
Area of Science:
- Cardiology
- Clinical Chemistry
- Inflammation Markers
Background:
- C-reactive protein (CRP) is an inflammatory marker associated with cardiovascular risk.
- Quantitative CRP (QtCRP) and highly sensitive CRP (hs-CRP) differ in cost but not structure.
- Limited data exists on QtCRP and post-myocardial infarction (MI) complications in Hispanic populations.
Purpose of the Study:
- To investigate the predictive value of QtCRP levels for acute post-MI complications in a Hispanic population.
- To identify a potential QtCRP predictor range for acute post-MI complications.
- To correlate QtCRP levels with specific post-MI events like sudden death, heart failure, reinfarction, and PTCA.
Main Methods:
- Observational analytic pilot study design.
- QtCRP blood levels measured 24 hours post-MI.
- Patients followed for one month to identify Emergency Room visits and post-MI complications (chest pain, heart failure, reinfarction, cardiac death).
Main Results:
- 20 acute MI patients studied; 14 experienced secondary endpoints (all underwent PTCA).
- Two patients re-infarcted; one developed heart failure. No deaths occurred.
- QtCRP levels ≥6.07 mg/dl correlated with complications; levels ≤1.91 mg/dl did not.
Conclusions:
- Elevated QtCRP levels correlate with secondary post-MI endpoints (re-infarction, heart failure, PTCA).
- A probable predictive range for QtCRP blood levels in patients with or without acute MI complications was identified.
Introduction:
The association between ischemic cardiomyopathy and C reactive protein (CRP) as an acute-phase inflammatory reactant has been reported. Increased highly sensitive C-reactive protein levels have been associated with a higher cardiovascular risk. We found no appreciable structural differences between Quantitative CRP and Highly Sensitive CRP but we found differences cost of both tests. Data addressing a relationship between QtC reactive protein levels and acute post myocardial infarction complications in Hispanic population was collected. Our study aims to provide a new element of prediction for the diagnosis of acute post myocardial infarction omplications in a Hispanic population. Also we could identify the possible presence of a QtCRP predictor range associated with acute post MI complication. We determined the presence of the primary endpoint of sudden death and secondary endpoints of heart failure, reinfarction and revascularization (PTCA) acute post myocardial infarction complications in a Hispanic population and after an acute myocardial infarction correlated them with QtC reactive protein levels.
Methodology:
This was an observational analytic pilot study. After the consent form was signed, QtCRP blood levels were taken 24 hours after the cardiac event. We followed the patient for one month after the acute event identifying further visits to the Emergency Room and determined the presence of post acute infarction complications (chest pain, heart failure, reinfarction and cardiac death) during that period of time. Then, we determined the relationship between the QtCRP level and the type of acute postinfarction complication.
Results:
We examined 20 acute myocardial infarction subjects and 14 of them developed secondary endpoints (all 14 of them had PTCA intervention). Two patients reinfarcted and 1 developed heart failure. There were no deaths. Levels of QtCRP of 6.07 mg/dl or more were associated with acute post infarction cardiovascular complications (secondary end points). Levels of QtCRP of 1.91 mg/dl or less were not associated with acute post infarction cardiovascular complications. Levels between 1.91 and 6.07 did not correlate well with the occurrence of complications.
Conclusions:
There seems to be a correlation between elevated QtCRP levels and secondary end points such as re-infarction, heart failure and PTCA. There is a probable identification range of QtCRP blood levels in patients with or without acute post IM complications.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Acute Coronary Syndrome I: Introduction
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations