Predictive Value of High-Sensitivity CRP Level on the No-Reflow Phenomenon in STEMI Patients

Area of Science:

• Cardiology
• Biomarkers
• Interventional Cardiology

Background:

• Increased high-sensitivity C-reactive protein (hs-CRP) levels are associated with the no-reflow phenomenon.
• Reperfusion injury can occur even with timely primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI).
• Understanding predictors of no-reflow is crucial for optimizing STEMI management.

Purpose of the Study:

• To evaluate the influence of hs-CRP levels on the incidence of the no-reflow phenomenon in STEMI patients.
• To identify potential hs-CRP cutoff values for predicting no-reflow and reperfusion injury risk.

Main Methods:

• A cohort of 182 STEMI patients with symptom onset < 12 hours, who underwent pPCI, were included.
• hs-CRP levels were measured on admission using Cobas assay.
• Patients were stratified into successful reperfusion (TIMI flow grade 3) and no-reflow (TIMI flow grade ≤ 2) groups.

Main Results:

• Median hs-CRP levels were significantly higher in patients with no-reflow (37.90 mg/L) compared to those with successful reperfusion (8.5 mg/L) (p < 0.0001).
• Receiver operating characteristic (ROC) curve analysis yielded an area under the curve (AUC) of 0.73 (95% CI, 0.64-0.81).
• An hs-CRP cutoff value of 18.0 mg/L was identified as a predictor for the no-reflow phenomenon (p=0.0001).

Conclusions:

• Elevated hs-CRP levels are significantly associated with the no-reflow phenomenon in STEMI patients treated with pPCI.
• An hs-CRP cutoff of 18.0 mg/L may help identify STEMI patients at increased risk for reperfusion injury.
• hs-CRP serves as a potential biomarker for predicting adverse outcomes post-pPCI in STEMI.