High-sensitivity C-reactive protein as a predictor of cardiovascular events after ST-elevation myocardial infarction
Daniel Rios Pinto Ribeiro1, Adriane Monserrat Ramos1, Pedro Lima Vieira1
1Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
Insights
High-sensitivity C-reactive protein did not predict recurrent cardiovascular events after ST-elevation myocardial infarction. However, elevated levels independently predicted 30-day mortality in these patients.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Research
Background:
- The prognostic value of high-sensitivity C-reactive protein (hs-CRP) for major adverse cardiovascular events (MACE) after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is debated.
- Understanding hs-CRP's role can refine risk stratification in STEMI patients undergoing primary PCI.
Purpose of the Study:
- To evaluate the association between hs-CRP levels and the risk of recurrent MACE in STEMI patients treated with primary PCI.
- To determine if hs-CRP is an independent predictor of short-term adverse outcomes, including mortality.
Main Methods:
- A prospective cohort study of 300 STEMI patients (age >18) treated with primary PCI.
- hs-CRP levels measured by nephelometry; clinical data and risk scores (TIMI, GRACE) collected.
- Patients followed for 30 days post-infarction for MACE, with statistical analysis using t-tests, Mann-Whitney, chi-square, and logistic regression.
Main Results:
- No significant association found between hs-CRP and recurrent MACE (p=0.11).
- hs-CRP independently predicted 30-day mortality after adjustment for TIMI (OR 1.27, p=0.005) and GRACE (OR 1.26, p=0.007) risk scores.
Conclusions:
- hs-CRP is not a predictor of combined MACE within 30 days post-primary PCI in STEMI patients.
- hs-CRP serves as an independent predictor of 30-day mortality in this patient population.
Background:
The association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.
Objective:
To investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.
Methods:
This prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.
Results:
The mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.
Conclusion:
Although high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.
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