C-reactive protein in acute myocardial infarction: association with heart failure

Berton, Giuseppe; Cordiano, Rocco; Palmieri, Rosa; Pianca, Sigismondo; Pagliara, Valeria; Palatini, Paolo

doi:10.1016/s0002-8703(03)00098-x

Cited by 116 publications

(84 citation statements)

References 23 publications

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“…Therefore, it is conceivable that the inflammatory injury and haemodynamic changes related to AMI [12] caused a greater leakage of urinary albumin in subjects with diabetes and associated glomerular damage. A recent study has demonstrated an association between C-reactive protein (a sensitive marker of inflammation) and microalbuminuria [30], and previous results from our laboratory indicate that C-reactive protein is a strong independent predictor of mortality in subjects with AMI [31]. The negative interaction between diabetes and ACR with respect to mortality suggests that microalbuminuria is the overriding factor in the setting of AMI because it reflects a heavily compromised clinical situation, and microalbuminuria was more common among the diabetic individuals than the non-diabetic individuals.…”

Section: Discussionmentioning

confidence: 61%

Albumin excretion in diabetic patients in the setting of acute myocardial infarction: association with 3-year mortality

Berton¹,

Cordiano²,

Palmieri³

et al. 2004

Diabetologia

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Aims/hypothesis. Diabetes mellitus is associated with increased mortality in subjects with acute myocardial infarction (AMI). We aimed to estimate the risk of mortality in AMI patients with and without diabetes using the urinary albumin : creatinine ratio (ACR).Methods. This is a prospective study of 121 consecutive, non-selected diabetic AMI patients, 121 age-and sex-matched non-diabetic AMI patients and 61 diabetic non-AMI outpatients as control subjects. All data were obtained during the first 7 days of hospitalisation and each AMI patient was followed for a period of exactly 3 years. Baseline ACR RIA measurements were made on the 1st, 3rd and 7th days of admission. Results. Adjusted ACR values were significantly higher in the diabetic AMI patients than in the diabetic control outpatients (p<0.0001), and a significant difference was observed between the weekly ACR slopes for these two groups (p<0.0001). Microalbuminuria was more prevalent in the diabetic AMI patients than in the non-diabetic AMI patients on the 1st day (62% vs 46%, p=0.01) and 3rd day (41% vs 29%, p=0.04). Among the AMI patients with normoalbuminuria (ACR <30 µg/mg), the mortality rate was 11.6% for the patients without diabetes and 33.8% for those with diabetes (p=0.001). The mortality rate was much higher among the AMI patients with microalbuminuria (ACR ≥30 µg/mg) and similar for the diabetic (68.0%) and non-diabetic patients (74.3%). In a multivariable Cox model, ACR (p<0.0001) and diabetes status (p=0.01) were associated with adverse outcome even when several other clinical variables were included in the model. Furthermore, a negative interaction was found between diabetes and ACR (p=0.01). Conclusions/interpretation. Microalbuminuria frequently occurs in diabetic and non-diabetic AMI patients during the first 3 days of admission to hospital and can be used to identify subjects at high risk of mortality.

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Section: Discussionmentioning

confidence: 61%

Albumin excretion in diabetic patients in the setting of acute myocardial infarction: association with 3-year mortality

Berton¹,

Cordiano²,

Palmieri³

et al. 2004

Diabetologia

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“…14,15) Previous some studies have demonstrated that CRP, an acute phase representative protein, is associated with various complications including cardiac events in AMI. 16,17) SAA, also an important acute phase inflammatory protein, has an expanded dynamic range with different kinetics compared with CRP and is reported to be a more sensitive indicator of inflammation in some noncardiovascular inflammatory conditions. 18) When in vivo inflammation occurs, synthesis of SAA, as well as CRP, in the liver is accelerated by inflammatory cytokines.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] On the other hand, there is now increasing evidence that acute coronary syndrome (ACS) is an inflammatory condition. [9][10][11] It is likely that smoking induces inflammation, an atherogenic lipid profile, and a propensity to thrombosis, thereby promoting the development of coronary atherothrombosis. However, it is uncertain if chronic inflammation, which is provoked by smoking, plays an etiologic role in 'smoker's paradox'.…”

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confidence: 99%

<b>The Etiology of ‘Smoker’s Paradox’ in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>

Katayama¹,

Iwasaki²,

Sakoda³

et al. 2008

Int. Heart J.

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SUMMARYDespite increased risk for coronary artery disease and acute myocardial infarction (AMI), prior studies have found that smokers with AMI have lower mortality rates than nonsmokers, a phenomenon often termed 'smoker's paradox'. The present study was designed to examine the etiology of 'smoker's paradox', especially with respect to the association with inflammation.The subjects included 528 consecutive AMI patients who were admitted within 24 hours of onset and underwent successful coronary intervention. Of the 528 subjects, 232 (44%) were smokers.The cardiac mortality rates over a 6 month period was significantly lower in the smoking group than the nonsmoking group (3% versus 9%, P = 0.01). There were significantly more male patients in the smoking group, and the smoking group was significantly younger than the nonsmoking group (P < 0.0001). The value of high sensitivity C-reactive protein (hs-CRP) on admission and 24 hours after onset, and serum amyloid A protein (SAA) were significantly higher, and acute phase BNP was significantly lower (hs-CRP on admission 1.36 ± 1.03 mg/dL versus 0.75 ± 0.82 mg/dL, P = 0.02, hs-CRP at 24 hours 3.86 ± 4.32 mg/dL versus 2.90 ± 3.46 mg/dL, P = 0.008, SAA; 288 ± 392 µg/dL versus 176 ± 206 µg/dL, P < 0.05, BNP; 248 ± 342 pg/mL versus 444 ± 496 pg/mL, P = 0.0002) in the smoking group than in the nonsmoking group. The early ST-segment resolution rate was higher in the smoking group compared with the nonsmoking group (80% versus 66%, P = 0.003).The reason why smokers with AMI have lower mortality rates than nonsmokers, the so-called 'smoker's paradox', is believed to be because smoking induces inflammation and smokers may have less damage to microvascular function after primary percutaneous coronary intervention. (Int Heart J 2008; 49: 13-24) Key words: Myocardial infarction, Smoking, Inflammation EVEN though many epidemiologic studies have shown that cigarette smoking is associated with higher rates of myocardial infarction and death from coronary From the

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“…Studies conducted (Grobusch et al, 1999;El-Badry et al, 1995;Giurgie, 2005;Awadallah et al, 2006) observed significantly higher (p<0.001) levels of caeruloplasmin where as (Berton et al, 2003;Bhagat et al, 2003;Sivaraman et al, 2004;Kulsoom et al, 2006;Boncler et al, 2006) observed higher levels of C-reactive protein in patients. Shukla et al, (2006) stated elevated levels of caeruloplasmin as a risk factor for acute myocardial infarct patients.…”

Section: Lipoprotein (A) and Lipid Peroxidationmentioning

confidence: 95%

Cardiovascular Risk Factors in Elderly Normolipidaemic Acute Myocardial Infarct Patients

Kumar¹

2012

Recent Advances in Cardiovascular Risk Factors

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C-reactive protein in acute myocardial infarction: association with heart failure

Cited by 116 publications

References 23 publications

Albumin excretion in diabetic patients in the setting of acute myocardial infarction: association with 3-year mortality

Albumin excretion in diabetic patients in the setting of acute myocardial infarction: association with 3-year mortality

<b>The Etiology of ‘Smoker’s Paradox’ in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>

Cardiovascular Risk Factors in Elderly Normolipidaemic Acute Myocardial Infarct Patients

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C-reactive protein in acute myocardial infarction: association with heart failure

Cited by 116 publications

References 23 publications

Albumin excretion in diabetic patients in the setting of acute myocardial infarction: association with 3-year mortality

Albumin excretion in diabetic patients in the setting of acute myocardial infarction: association with 3-year mortality

<b>The Etiology of &lsquo;Smoker&rsquo;s Paradox&rsquo; in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>

Cardiovascular Risk Factors in Elderly Normolipidaemic Acute Myocardial Infarct Patients

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<b>The Etiology of ‘Smoker’s Paradox’ in Acute Myocardial Infarction With Special Emphasis on the Association With Inflammation</b>