C-Reactive Protein as a Risk Marker for Post-Infarct Heart Failure over a Multi-Year Period

Area of Science:

• Cardiology
• Biomarkers
• Inflammation

Background:

• Inflammatory responses following acute ST-elevation myocardial infarction (STEMI) are implicated in the development of post-infarct heart failure (HF).
• Guideline-based therapies, including percutaneous coronary intervention, are standard for STEMI management, yet HF remains a complication.

Purpose of the Study:

• To evaluate the prognostic value of high-sensitivity C-reactive protein (CRP) concentrations for predicting long-term heart failure (HF) after STEMI.
• To assess the association between persistent inflammation, indicated by CRP levels, and the risk of heart failure hospitalization (HFH).

Main Methods:

• Prospective study of 204 patients with a first STEMI, treated with guideline-based therapies.
• Measurement of high-sensitivity C-reactive protein (CRP) at admission, 24 hours (CRP24), discharge (CRP_DC), and one month (CRP1M) post-STEMI.
• Long-term follow-up (median 5.6 years) for heart failure hospitalization (HFH) as the primary endpoint.

Main Results:

• Heart failure hospitalization (HFH) occurred in 11.8% of patients over a median of 5.6 years.
• Significantly higher CRP levels (CRP24, CRP_DC, CRP1M) were observed in patients who experienced HFH compared to those who did not.
• Multivariable analysis indicated that CRP_DC significantly improved the prediction of long-term HFH, with CRP1M ≥ 2 mg/L associated with increased risk.

Conclusions:

• Persistent elevation of CRP post-STEMI is a valuable prognostic marker for long-term heart failure risk.
• Ongoing systemic inflammation, as indicated by CRP, contributes to HF development despite optimal STEMI therapies.
• CRP measurements aid in risk stratification for identifying patients at higher risk of heart failure hospitalization after STEMI.