Περίληψη:
It has been reported that increased levels of C-reactive protein are
related to adverse long-term prognosis in the setting of ST-segment
elevation acute myocardial infarction (MI). In previous studies, the
timing of C-reactive protein determination has varied widely. In the
present study, serial high-sensitivity C-reactive protein (hsCRP)
measurements were performed to investigate if any of the measurements is
superior regarding long-term prognosis. A total of 861 consecutive
patients admitted for ST-segment elevation MI and treated with
intravenous thrombolysis within the first 6 hours from the index pain
were included. HsCRP levels were determined at presentation and at 24,
48, and 72 hours. The median follow-up time was 3.5 years. New nonfatal
MI and cardiac death were the study end points. By the end of follow-up,
cardiac death was observed in 22.4% and nonfatal MI in 16.1% of the
patients. HsCRP levels were found to be increasing during the first 72
hours. Multivariate Cox regression analysis demonstrated that hsCRP
levels a presentation were an independent predictor of the 2 end points
(relative risk [RR] 2.8, p = 0.002, and RR 2.1, p = 0.03, for MI and
cardiac death, respectively), while hsCRP levels at 24 hours did not
yield statistically significant results (RR 1.4, p = 0.40, and RR 1.1, p
= 0.80, for MI and cardiac death, respectively). The corresponding RRs
at 48 hours were 1.2 (p = 0.5) for MI and 3.2 (p = 0.007) for cardiac
death and at 72 hours were 1.6 (p = 0.30) for MI and 3.9 (p <0.001) for
cardiac death. In conclusion, hsCRP levels at presentation represent an
independent predictor for fatal and nonfatal events during long-term
follow-up. HsCRP levels at 48 and 72 hours, which are close to peak
hsCRP levels, independently predict only cardiac death. (c) 2013
Elsevier Inc. All rights reserved. (Am J Cardiol 2013;111:26-30)
Συγγραφείς:
Makrygiannis, Stamatis S.
Ampartzidou, Olga S.
Zairis, Michael
N.
Patsourakos, Nikolaos G.
Pitsavos, Christos
Tousoulis,
Dimitris
Prekates, Athanasios A.
Foussas, Stefanos G. and
Cokkinos, Dennis V.
