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Predictive Performance of Serum Monomeric C-Reactive Protein for Major Adverse Cardiovascular Events in Patients With
Ye Zhang1, Shuai Wang2, Zhengya Fang1
1Department of Cardiovascular Medicine, Liyang City People's Hospital, 213300 Liyang, Jiangsu, China.
Insights
Serum monomeric C-reactive protein (mCRP) effectively predicts major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) one year after discharge. This biomarker shows strong predictive performance, aiding in risk stratification for STEMI survivors.
Area of Science:
- Cardiology
- Biomarker Discovery
- Clinical Research
Background:
- Patients with acute ST-segment elevation myocardial infarction (STEMI) face a high risk of major adverse cardiovascular events (MACE) post-discharge.
- Identifying reliable biomarkers is crucial for risk stratification and management of STEMI patients.
- Serum monomeric C-reactive protein (mCRP) is a potential biomarker for cardiovascular events.
Purpose of the Study:
- To investigate the predictive performance of serum monomeric C-reactive protein (mCRP) for MACE.
- To assess mCRP's utility in identifying high-risk patients with acute STEMI at one-year post-discharge.
Main Methods:
- Retrospective analysis of 242 acute STEMI patients undergoing emergency Percutaneous Coronary Intervention (PCI).
- Patients were categorized into MACE (n=58) and non-MACE (n=184) groups.
- Univariate, binary logistic regression, and Receiver Operating Characteristic (ROC) curve analyses were employed.
Main Results:
- Serum mCRP levels (within 24 hours of admission) were significantly different between MACE and non-MACE groups (p < 0.05).
- mCRP showed a positive correlation with cardiac troponin I (cTnI) levels (r = 0.196, p < 0.05).
- mCRP, left ventricular ejection fraction (LVEF), and cTnI were identified as independent predictors of one-year MACE (p < 0.05).
- ROC analysis demonstrated a strong predictive performance for mCRP with an Area Under the Curve (AUC) of 0.840 (p < 0.001).
Conclusions:
- Serum monomeric C-reactive protein (mCRP) demonstrates significant predictive value for MACE in acute STEMI patients.
- mCRP offers superior predictive performance compared to other assessed parameters for one-year post-discharge outcomes.
- mCRP can serve as a valuable biomarker for identifying high-risk STEMI patients needing closer monitoring and intervention.
Aims/Background:
Patients with acute ST-segment elevation myocardial infarction (STEMI) are at high risk of major adverse cardiovascular events (MACE) even after discharge, underscoring the need to identify reliable biomarkers. Therefore, this study aimed to investigate the predictive performance of serum monomeric C-reactive protein (mCRP) for MACE in patients with acute STEMI at one-year post-discharge.
Methods:
A retrospective analysis was conducted on 242 patients with acute STEMI who underwent emergency Percutaneous Coronary Intervention (PCI) in Liyang City People's Hospital between January 2021 and December 2023. Patients were divided into the MACE group (n = 58) and the non-MACE group (n = 184) based on major adverse cardiovascular events. Univariate and binary logistic regression analyses were performed to identify factors influencing MACE events in patients with acute STEMI treated with emergency PCI. Furthermore, predictive performance was assessed using receiver operating characteristic curve (ROC) analysis.
Results:
There were no statistically significant differences (p > 0.05) between the groups in terms of age, gender, body mass index (BMI), smoking history, alcohol consumption history, history of hypertension, left ventricular end-diastolic diameter (LVEDD), total cholesterol (TC), triglycerides (TG), B-type natriuretic peptide (BNP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and left ventricular end-diastolic volume (LVEDV). Comparisons of mCRP (within 24 hours of admission), left ventricular ejection fraction (LVEF), and cardiac troponin I (cTnI) showed statistically significant differences (p < 0.05). Monomeric CRP demonstrated a positive correlation with cTnI levels (r = 0.196, p < 0.05). Binary logistic regression analysis identified mCRP, LVEF, and cTnI levels as independent predictors of one-year post-discharge MACE in patients with acute STEMI (p < 0.05). ROC analysis yielded an area under the curve of 0.840 for mCRP (standard error = 0.028; 95% CI, 0.785-0.896, p < 0.001). At the Youden index of 0.50, mCRP demonstrated a sensitivity of 77.59%, and a specificity of 72.83%.
Conclusion:
Monomeric CRP exhibits superior predictive performance for MACE in acute STEMI patients at one-year post-discharge.
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