Enhanced Inflammation is a Marker for Risk of Post-Infarct Ventricular Dysfunction and Heart Failure

Area of Science:

• Cardiology
• Biomarkers
• Inflammation

Background:

• Acute ST-segment elevation myocardial infarction (STEMI) triggers inflammatory responses.
• Inflammation post-STEMI can lead to left ventricular systolic dysfunction (LVSD) and heart failure (HF).
• The predictive value of C-reactive protein (CRP) for long-term cardiac outcomes after STEMI requires further investigation.

Purpose of the Study:

• To determine if high-sensitivity C-reactive protein (hs-CRP) concentration predicts long-term LVSD and HF following STEMI.
• To assess the relationship between serial hs-CRP measurements and the development of LVSD and HF.

Main Methods:

• Prospective evaluation of 204 patients with a first STEMI.
• Serial hs-CRP measurements at admission, 24 hours (CRP24), discharge (CRPDC), and 1 month (CRP1M).
• Assessment of LVSD at 6 months (LVSD6M) and HF hospitalizations during long-term follow-up (median 5.6 years).

Main Results:

• LVSD6M occurred in 17.6% of patients; 45.7% of these patients were hospitalized for HF versus 4.9% without LVSD6M.
• Patients with LVSD6M exhibited higher CRP24, CRPDC, and persistent CRP1M (≥ 2 mg/L) compared to those without LVSD6M.
• CRP24 ≥ 19.67 mg/L improved prediction of LVSD6M (OR 1.47, p < 0.01); highest CRP levels were observed in patients with LVSD6M who developed HF.

Conclusions:

• Elevated hs-CRP concentration during STEMI is a significant predictor of long-term LVSD and subsequent HF.
• Serial hs-CRP measurements, particularly CRP24, can enhance risk stratification for adverse cardiac remodeling and events post-STEMI.
• hs-CRP serves as a valuable synergistic biomarker for identifying STEMI patients at high risk for developing chronic LVSD and heart failure.