High-Sensitivity C-Reactive Protein as a Predictor of Cardiovascular Events after ST-Elevation Myocardial Infarction

Background

The association between high-sensitivity C-reactive protein and recurrent majoradverse cardiovascular events (MACE) in patients with ST-elevation myocardialinfarction who undergo primary percutaneous coronary intervention remainscontroversial.

Objective

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

Methods

This prospective cohort study included 300 individuals aged >18 years who werediagnosed with ST-elevation myocardial infarction and underwent primarypercutaneous coronary intervention at a tertiary health center. An instrumentevaluating 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 patientswere followed-up during hospitalization and up to 30 days after infarction for theoccurrence of MACE. Student''s t, Mann-Whitney, chi-square, and logistic regressiontests were used for statistical analyses. P values of ≤0.05 were consideredstatistically significant.

Results

The mean age was 59.76 years, and 69.3% of patients were male. No statisticallysignificant association was observed between high-sensitivity C-reactive proteinand recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein wasindependently 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 majorcardiovascular events within 30 days after ST-elevation myocardial infarction inpatients who underwent primary angioplasty and stent implantation, it was anindependent predictor of 30-day mortality.