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Predictive value of high sensitivity C-reactive protein on progression to heart failure occurring after the first

Zohair A Al Aseri1, Syed Shahid Habib2, Ameer Marzouk3

  • 1Department of Emergency Medicine, King Saud University & Medical City, Riyadh, Saudi Arabia.

Vascular Health and Risk Management
|August 15, 2019
PubMed

Insights

High sensitivity C-reactive protein (hsCRP) measured during the first acute myocardial infarction (AMI) can predict heart failure. Elevated hsCRP levels indicate a higher risk of developing myocardial dysfunction and subsequent heart failure.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Medicine

Background:

  • High sensitivity C-reactive protein (hsCRP) is a known predictor of myocardial dysfunction following acute coronary syndromes.
  • Understanding the role of hsCRP in the early stages of acute myocardial infarction (AMI) is crucial for predicting long-term cardiac outcomes.

Purpose of the Study:

  • To investigate the association between hsCRP levels measured at the time of first AMI and the development of myocardial dysfunction and heart failure.
  • To evaluate hsCRP as a predictive biomarker for adverse cardiac events post-AMI.

Main Methods:

  • A prospective study involving 227 patients admitted with AMI.
  • hsCRP levels were measured upon emergency department admission, 7 days post-AMI, and at 12 weeks.
  • Myocardial function and heart failure incidence were assessed at 12 months follow-up.

Main Results:

  • Patients with high hsCRP levels at admission had significantly lower ejection fraction at follow-up compared to those with low hsCRP (37.29±12.97% vs. 43.85±11.77%, p<0.0198).
  • hsCRP showed a significant inverse correlation with left ventricular ejection fraction (r=-0.283, p<0.01).
  • Heart failure developed in 38.1% of patients, with a higher incidence in the high hsCRP group (23.6% vs. 14.5%, OR 2.4, p=0.028). Receiver operating characteristic analysis indicated 83% sensitivity and 79% specificity for hsCRP in predicting heart failure.

Conclusions:

  • Elevated hsCRP levels upon initial AMI diagnosis are a significant predictor of subsequent myocardial dysfunction and heart failure.
  • hsCRP may play a critical role in the pathophysiology of heart failure development after myocardial infarction.

Keywords:
Lipoprotein(a)acute myocardial infarctionejection fractionheart failurehigh sensitivity C-reactive protein

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