The Prognostic Role of C-Reactive Protein Velocity in Patients with First Acute Myocardial Infarction

Area of Science:

• Cardiology
• Biomarkers
• Inflammation Research

Background:

• Inflammation is critical in acute myocardial infarction (AMI) pathophysiology.
• Static C-reactive protein (CRP) levels offer limited prognostic insight.
• CRP velocity (CRPv) may better reflect dynamic inflammatory responses.

Purpose of the Study:

• To investigate the prognostic significance of CRPv in patients experiencing their first AMI.
• To determine if CRPv provides additional prognostic value beyond established risk factors.

Main Methods:

• Calculated CRPv from CRP levels at admission and 24 ± 8 hours.
• Derived a prognostic CRPv cut-off (1.36 mg/L/h) using spline analysis.
• Followed 604 first AMI patients for a composite endpoint (cardiovascular death, non-fatal AMI, heart failure hospitalization).

Main Results:

• Higher hs-cTnT and NT-proBNP were associated with elevated CRPv (≥ 1.36 mg/L/h).
• Patients with high CRPv had significantly lower event-free survival (66.7% vs. 85.5%).
• CRPv independently predicted adverse outcomes and improved risk model discrimination (p < 0.001).

Conclusions:

• CRP velocity is a robust, independent predictor of adverse outcomes in first AMI.
• CRPv offers incremental prognostic value beyond traditional clinical and biomarker indices.
• Feasible and low-cost CRPv can enhance early clinical risk stratification for AMI patients.