CRP velocity and short-term mortality in ST segment elevation myocardial infarction

Milwidsky, Assi; Ziv‐Baran, Tomer; Letourneau-Shesaf, Sevan; Keren, Gad; Taieb, Philippe; Berliner, Shlomo; Shacham, Yacov

doi:10.1080/1354750x.2017.1279218

Cited by 25 publications

(23 citation statements)

References 21 publications

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“…The association between CRP levels and adverse outcomes in AMI patients is well established. 21 In the study including 492 AMI patients, CRP was significantly higher among those who died within 30 days of admission (1.42 mg/L versus 0.18 mg/L, p < 0.001) and independently associated with 30-day mortality (odds ratio 1.39, 95% confidence interval 1.20–1.62, p < 0.001). However, Bielas and coworkers 22 were the first to reveal a significant direct correlation between the ASD symptom severity and the inflammatory response in AMI.…”

Section: Myocardial Infarction-triggered Asd and Subclinical Inflammamentioning

confidence: 88%

Acute stress disorder and C-reactive protein in patients with acute myocardial infarction

Seferović

Ašanin

Ristić

2018

Eur J Prev Cardiolog

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Section: Myocardial Infarction-triggered Asd and Subclinical Inflammamentioning

confidence: 88%

Acute stress disorder and C-reactive protein in patients with acute myocardial infarction

Seferović

Ašanin

Ristić

2018

Eur J Prev Cardiolog

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“…Systemic inflammatory response is observed in ACS. A relationship between proinflammatory markers and clinical outcomes was found in patients with STEMI [ 19 ]. It has been proven that higher blood leukocyte levels are associated with higher mortality rate and in-hospital complications [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Prognostic Significance of High-Sensitive Troponin I Increase during Hospital Stay in Patients with Acute Myocardial Infarction and Non-Obstructive Coronary Arteries

Jędrychowska¹,

Januszek

Wańha

et al. 2020

Medicina

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Background and Objectives: A topic already widely investigated is the negative prognostic value regarding the extent of high sensitive troponin I (hs-TnI) increases among patients with myocardial infarction (MI) and obstructive coronary atherosclerosis compared to a group of patients with MI and non-obstructive coronary atherosclerosis (MINOCA). Thus, the aim of this study was to evaluate the prognostic value concerning the extent of hs-TnI increase on clinical outcomes among patients with a MINOCA working diagnosis. Materials and Methods: We selected 337 consecutive patients admitted to hospital with a working diagnosis of MINOCA. The patients were divided in three groups according to the extent of hs-TnI increase during hospitalization (increase ≤5-times above the limit of the upper norm, >5 and ≤20-times, and >20-times). The study endpoints included all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE; cerebral stroke and transient ischemic attacks, MI, coronary artery revascularization, either percutaneous coronary intervention or coronary artery bypass grafting and all-cause mortality). Results: During the mean follow-up period of 516.1 ± 239.8 days, using Kaplan–Meier survival curve analysis, significantly higher mortality rates were demonstrated among patients from the group with the greatest hs-TnI increase compared to the remaining groups (p = 0.01) and borderline values for MACCE (p = 0.053). Multivariable cox regression analysis did not confirm hs-TnI among factors related to increased MACCE or all-cause mortality rates. Conclusion: While a relationship between clinical outcomes and the extent of the hs-TnI increase among patients with a MINOCA working diagnosis remains, it does not seem to be not as strong as it is in patients with obstructive coronary atherosclerosis.

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“…CRP and cTnT values were measured at hospital admission, 6 ± 2 h, 12 ± 4 h, 24 ± 8 h and then daily until day 4 after PCI or discharge [15]. CRPv was defined as the difference between CRP 24 ± 8 h and CRP at hospital admission, divided by the time (in h) elapsed during the two examinations [10].…”

Section: Study Design Clinical Assessments and Endpoint Definitionsmentioning

confidence: 99%

“…CRP elevation is directly related to a greater extent of myocardial tissue damage [3,5,6] with subsequent major adverse cardiac events (MACE) [7][8][9]. Recently, C-reactive protein velocity (CRPv) has been considered as a very early and more sensitive risk marker compared to single time point measurements [10]. However, the exact role and comparative prognostic value of CRP level change over time versus single time point measurements is still largely unclear.…”

Section: Introductionmentioning

confidence: 99%

C-reactive protein velocity predicts microvascular pathology after acute ST-elevation myocardial infarction

Holzknecht

Tiller

Reindl

et al. 2021

International Journal of Cardiology

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Background: The role of C-reactive protein velocity (CRPv) as an early and sensitive marker of an excessive inflammatory response in the setting of acute ST-elevation myocardial infarction (STEMI) is only poorly understood. The aim of this study was to investigate, in patients with STEMI treated with primary percutaneous coronary intervention (PCI), the association of CRPv with microvascular infarct pathology. Methods and results: This prospective cohort study included a total of 316 patients with STEMI undergoing PCI. CRPv was defined as the difference between CRP 24 ± 8 h and CRP at hospital admission, divided by the time (in h) that have passed during the two examinations. The association of biomarker levels with cardiac magnetic resonance (CMR)-determined microvascular obstruction (MVO) was evaluated. CMR was performed at a median of 3 [interquartile range 2-4] days after PCI. After adjustment for cardiac troponin T (cTnT), anterior infarction and TIMI flow pre and post-PCI, CRPv (odds ratio 2.70, 95% confidence interval (CI) 1.54-4.73; p = 0.001) remained significantly associated with the occurrence of MVO. CRPv (area under the curve [AUC] 0.76, 95% CI 0.71-0.81; p < 0.001) was a better predictor for MVO compared to 24 h CRP (AUC difference: 0.03, p = 0.002). The addition of CRPv to peak cTnT resulted in a higher AUC for MVO prediction than peak cTnT alone (AUC 0.86, 95% CI 0.82-0.90; p < 0.001 vs. AUC 0.84, 95% CI 0.79-0.88; p < 0.001. AUC difference: 0.02, p = 0.042). Conclusions: In patients with STEMI treated with primary PCI, CRPv was associated with microvascular infarct pathology with a predictive value incremental to cTnT, suggesting CRPv as an early and sensitive biomarker for more severe infarct pathology and outcome.

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CRP velocity and short-term mortality in ST segment elevation myocardial infarction

Abstract: CRPv might be an independent and rapidly measurable biomarker for short-term mortality in patients presenting with STEMI.

Cited by 25 publications

References 21 publications

Acute stress disorder and C-reactive protein in patients with acute myocardial infarction

Acute stress disorder and C-reactive protein in patients with acute myocardial infarction

Long-Term Prognostic Significance of High-Sensitive Troponin I Increase during Hospital Stay in Patients with Acute Myocardial Infarction and Non-Obstructive Coronary Arteries

C-reactive protein velocity predicts microvascular pathology after acute ST-elevation myocardial infarction

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