CRP velocity and short-term mortality in ST segment elevation myocardial infarction

There is a known association between C-reactive protein (CRP) levels and adverse outcomes in patients presenting with ST-elevation myocardial infarction (STEMI). The optimal time frame to measure CRP for risk stratification is not known.

The aim of the current study was to evaluate the relation between the change in CRP velocity (CRPv) and 30-d mortality among STEMI patients.

We included consecutive patients with a diagnosis of STEMI who presented to Tel-Aviv Medical Center between 2008 and 2014 and had their CRP measured with a wide range assay (wr-CRP) at least twice during the 24 h after admission. CRPv was defined as the change in wr-CRP concentration (mg/l) divided by the change in time (in hours) between the two measurements.

The study population comprised of 492 patients, mean age was 62 ± 14, 80% were male. CRPv was significantly higher among patients who died within 30 d of admission (1.42 mg/l versus 0.18 mg/l, p < 0.001). In a multivariate regression model adjusted to multiple confounders, CRPv was independently associated with 30-d mortality (OR 1.39, 95% CI: 1.20-1.62, p < 0.001).

CRPv might be an independent and rapidly measurable biomarker for short-term mortality in patients presenting with STEMI.