Usefulness of C-reactive protein as a marker of early post-infarct left ventricular systolic dysfunction |
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Authors: | Iwona Swiatkiewicz Marek Kozinski Przemyslaw Magielski Joanna Gierach Tomasz Fabiszak Aldona Kubica Adam Sukiennik Eliano Pio Navarese Grazyna Odrowaz-Sypniewska Jacek Kubica |
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Institution: | Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland. i.swiat@wp.pl |
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Abstract: | Objective To assess the usefulness of in-hospital measurement of C-reactive protein (CRP) concentration in comparison to well-established risk factors as a marker of post-infarct left ventricular systolic dysfunction (LVSD) at discharge. Materials and methods Two hundred and four consecutive patients with ST-segment-elevation myocardial infarction (STEMI) were prospectively enrolled into the study. CRP plasma concentrations were measured before reperfusion, 24?h after admission and at discharge with an ultra-sensitive latex immunoassay. Results CRP concentration increased significantly during the first 24?h of hospitalization (2.4?±?1.9 vs. 15.7?±?17.0?mg/L; p?0.001) and persisted elevated at discharge (14.7?±?14.7?mg/L), mainly in 57 patients with LVSD (2.4?±?1.8 vs. 25.0?±?23.4?mg/L; p?0.001; CRP at discharge 21.9?±?18.6?mg/L). The prevalence of LVSD was significantly increased across increasing tertiles of CRP concentration both at 24?h after admission (13.2 vs. 19.1 vs. 51.5?%; p?0.0001) and at discharge (14.7 vs. 23.5 vs. 45.6?%; p?0.0001). Multivariate analysis demonstrated CRP concentration at discharge to be an independent marker of early LVSD (odds ratio of 1.38 for a 10?mg/L increase, 95?% confidence interval 1.01–1.87; p?0.04). Conclusion Measurement of CRP plasma concentration at discharge may be useful as a marker of early LVSD in patients after a first STEMI. |
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