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High-sensitivity C-reactive protein as a predictor of cardiovascular events after ST-elevation myocardial infarction.

Ribeiro DR, Ramos AM, Vieira PL, Menti E, Bordin OL, Souza PA, Quadros AS, Portal VL - Arq. Bras. Cardiol. (2014)

Bottom Line: P values of ≤0.05 were considered statistically significant.No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11).However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.

View Article: PubMed Central - PubMed

Affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.

ABSTRACT

Background: The association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.

Objective: To investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.

Methods: This prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.

Results: The mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.

Conclusion: Although high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.

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Bivariate analysis of high-sensitivity C-reactive protein (hs-CRP) in relation to30-day mortality after ST-elevation acute myocardial infarction (p = 0.05)
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f01: Bivariate analysis of high-sensitivity C-reactive protein (hs-CRP) in relation to30-day mortality after ST-elevation acute myocardial infarction (p = 0.05)

Mentions: When the patients were compared with respect to the occurrence of MACE within the first30 days after the index event, we observed a median hs-CRP of 8.0 mg/L (range, 3.7-23.5mg/L) in the group presenting with the endpoint and 6.4 mg/L (range, 3.1-17.2 mg/L) inthe remaining (p = 0.11; Table 3). Among thosewho developed heart failure, the median hs-CRP was 8.0 mg/L (range, 3.7-26.0 mg/L),while the median hs-CRP was 6.4 mg/L (range, 3.1-15.5 mg/L) in the group without heartfailure (p = 0.057). When hs-CRP was assessed in relation to death, there was asignificant association (p = 0.05; Figure 1). Thecauses of death and the respective hs-CRPs in each patient are shown in Table 4.


High-sensitivity C-reactive protein as a predictor of cardiovascular events after ST-elevation myocardial infarction.

Ribeiro DR, Ramos AM, Vieira PL, Menti E, Bordin OL, Souza PA, Quadros AS, Portal VL - Arq. Bras. Cardiol. (2014)

Bivariate analysis of high-sensitivity C-reactive protein (hs-CRP) in relation to30-day mortality after ST-elevation acute myocardial infarction (p = 0.05)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126763&req=5

f01: Bivariate analysis of high-sensitivity C-reactive protein (hs-CRP) in relation to30-day mortality after ST-elevation acute myocardial infarction (p = 0.05)
Mentions: When the patients were compared with respect to the occurrence of MACE within the first30 days after the index event, we observed a median hs-CRP of 8.0 mg/L (range, 3.7-23.5mg/L) in the group presenting with the endpoint and 6.4 mg/L (range, 3.1-17.2 mg/L) inthe remaining (p = 0.11; Table 3). Among thosewho developed heart failure, the median hs-CRP was 8.0 mg/L (range, 3.7-26.0 mg/L),while the median hs-CRP was 6.4 mg/L (range, 3.1-15.5 mg/L) in the group without heartfailure (p = 0.057). When hs-CRP was assessed in relation to death, there was asignificant association (p = 0.05; Figure 1). Thecauses of death and the respective hs-CRPs in each patient are shown in Table 4.

Bottom Line: P values of ≤0.05 were considered statistically significant.No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11).However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.

View Article: PubMed Central - PubMed

Affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.

ABSTRACT

Background: The association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.

Objective: To investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.

Methods: This prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.

Results: The mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.

Conclusion: Although high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.

Show MeSH
Related in: MedlinePlus