The predictive role of early CRP values for one-year mortality in the first 2 d after acute myocardial infarction. (3rd April 2022)

• Record Type: Journal Article
• Authors: Alkouri, Ahmad; Cybularz, Maria; Mierke, Johannes; Nowack, Thomas; Biedermann, Jonathan; Ulbrich, Stefan; Fischer, Julia; Heidrich, Felix M.; Jellinghaus, Stefanie; Speiser, Uwe; Linke, Axel; Pfluecke, Christian
• Is Part Of: Biomarkers. Volume 27:Number 3(2022)
• Page Start: 293
• Page End: 298
• Publication Date: 2022-04-03
• Subjects: Acute myocardial infarction -- remodelling -- heart failure: inflammation -- C-reactive protein (CRP); Biochemical markers -- Periodicals; 610.28
• DOI: 10.1080/1354750X.2022.2040591
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Background: An excessive inflammatory reaction after acute myocardial infarction (AMI) is known to be harmful. New anti-inflammatory therapies are required. Purpose: This study assessed the predictive role of early CRP in patients with STEMI. Methods: A total of 1003 patients with STEMI were analysed. A total of 180 patients with proven infection were excluded. CRP after 12, 24 and 48 h after pain onset were evaluated. Results: Of 823 patients, 103 (12.5%) died within one year after AMI. The deceased patients showed higher CRP, even after already 12 h (6 vs. 13 mg/l, p < .001), 24 h (13 vs. 25 mg/l, p < .001) and after 48 h (40 vs. 92 mg/l, p < .001). A CRP of ≥8 mg/l, 12 h after AMI, was found in 45% and was independently associated with long-term mortality (OR: 2.7, p = .03), after 24 h: CRP ≥ 18 mg/l in 44% (OR: 2.5, p = .03), after 48 h: CRP ≥ 53 mg/l in 44% (OR 1.9, p = .03). Early CRP values correlated strongly with the later maximum value of CRP ( p < .001). Conclusions: Already early CRP values are accurate for risk-prediction following AMI. By identifying patients who are beginning to develop an excessive inflammatory response, it may be possible to identify those who benefit from anti-inflammatory therapies.