Early Prognostic Usefulness of C-Reactive Protein Added to the Thrombolysis In Myocardial Infarction Risk Score in Acute Coronary Syndromes

Foussas, Stefanos; Zairis, Michael N.; Lyras, Anastassios G.; Patsourakos, Nikolaos G.; Tsirimpis, Vasilios G.; Katsaros, K.; Beldekos, Demetrios; Handanis, S.; Mytas, D.; Karidis, K.; Tselioti, P.; Prekates, A.; Ambrose, John A.

doi:10.1016/j.amjcard.2005.04.015

Cited by 56 publications

(44 citation statements)

References 11 publications

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“…11,12,14 Thus, SAA is considered more sensitive and useful than CRP as a marker of acute inflammatory response. [11][12][13][14] There is growing evidence that elevated CRP levels have prognostic value in patients with NSTE-ACS, [4][5][6][7] but data supporting the prognostic value of SAA are more limited. Liuzzo et al reported that elevated SAA on admission was associated with higher rates of revascularization, myocardial infarction, and death in patients with unstable angina without evidence of myocardial necrosis.…”

Section: Discussionmentioning

confidence: 99%

Serum Amyloid A is a Better Predictor of Clinical Outcomes than C-Reactive Protein in Non-ST-Segment Elevation Acute Coronary Syndromes

Kosuge

Ebina

Ishikawa

et al. 2007

Circ J

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Section: Discussionmentioning

confidence: 99%

Serum Amyloid A is a Better Predictor of Clinical Outcomes than C-Reactive Protein in Non-ST-Segment Elevation Acute Coronary Syndromes

Kosuge

Ebina

Ishikawa

et al. 2007

Circ J

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“…There is increased recognition that inflammation plays a key role in the pathogenesis and outcome of ACSs (3). Previous studies have constantly shown that high circulating levels of C-reactive protein (CRP) incur an increased risk of long-term cardiovascular mortality in patients with either ST-segment elevation MI (STEMI) (4-7), or non-ST-segment elevation ACSs (NSTE-ACS) (7)(8)(9)(10)(11). Elevated concentrations of CRP can also be found in subjects with ACS.…”

Section: Introductionmentioning

confidence: 99%

Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

Liyan

Zhang

Yong-hua

et al. 2008

Clinical Laboratory Analysis

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Diagnosis of cardiac ischemia in patients coming to emergency departments (ED) with symptoms of acute chest pain is often difficult. Many markers are sensitive and specific for the detection of myocardial necrosis but may not rise during reversible myocardial ischemia. Ischemia-modified albumin (IMA) has recently been shown to be a sensitive and early biochemical marker of ischemia. The variation laws were observed by measuring IMA and C-reactive protein (CRP) of 113 patients in ED within 12 hr after onset of chest pain. In the observation, blood was taken for IMA and CRP. Patients underwent standardized triage, diagnostic procedures, and treatment. Results of IMA and CRP were correlated with final diagnoses of nonischemic chest pain (NICP) and acute coronary syndrome (ACS). There were obvious distinction of IMA and CRP levels between the NICP and ACS groups. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS patients from NICP. The area under the curves of IMA is 0.948. The sensitivity and specificity of albumin cobalt binding (ACB) at a cutoff value of 70.0 units/mL were 94.4% and 82.6%, respectively. The area under the curves of CRP is 0.746. Sensitivity and specificity of CRP at a cutoff value of 3.16 mg/L were 70.0% and 73.9%, respectively. Negative predictive value (NPV) of IMA and CRP for ischemia origin was 79.2% and 38.6%, respectively. IMA may make an early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity and specificity of ACS.

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“…In studies assessing the prognostic value of initial cTnI and hs-CRP in STEMI, elevated levels were associated with adverse prognosis and lower rate of recanalization after fibrinolysis or PCI (balloon angioplasty or uncoated stent), 4,6,20,21 but negative correlations also coexisted. 7,10 There are no published data on the value of initial cTnI and hs-CRP level for predicting clinical outcomes after primary DES implantation in STEMI.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers on Admission for the Prediction of Cardiovascular Events After Primary Stenting in Patients with ST‐Elevation Myocardial Infarction

Jeong

Lee

et al. 2008

Clinical Cardiology

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Background: Several cardiac biomarkers have been shown to have predictive values for the development of cardiovascular disease and clinical outcome after events, and are now broadly used by clinicians. Little is known about the utility of these biomarker values on admission in ST-elevation myocardial infarction (STEMI) cases of primary drug-eluting stent (DES) implantation and intense medical therapy. Hypothesis: Because little is known about the utility of these biomarkers on admission in ST-elevation myocardial infarction (STEMI) in cases primary drug-eluting stent (DES) implantation and intense medical therapy, we evaluated clinical outcomes. Methods: We enrolled 207 consecutive STEMI patients treated with primary stenting (mean age, 57.3±12.0 y). We evaluated the association between B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), highsensitivity C-reactive protein (hs-CRP) on admission, and death, reinfarction, and new or worsening congestive heart failure (CHF) through 1 y. Results: In backward-elimination models including all biomarkers, only the cTnI level was retained as a predictor of 1-y CHF (odds ratio [OR]: 1.017, 95% confidence interval [CI]: 1.001-1.034, p = 0.039). There were no predictors in terms of 1-y death, reinfarction, and composite endpoint. When we applied a simple score system, in which patients were categorized on the basis of the number of elevated biomarkers, the 1-y risks of death (p = 0.600), reinfarction (p = 0.185), and composite endpoint (p = 0.620) did not increase in proportion to the number of elevated biomarkers on admission. One-y CHF only tended to increase according to the number of elevated biomarkers (p = 0.067). Conclusions:The use of cardiac biomarkers on admission, in each or in combination, had only a minimal impact for the prediction of long-term cardiovascular events after primary stenting in STEMI patients.

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Early Prognostic Usefulness of C-Reactive Protein Added to the Thrombolysis In Myocardial Infarction Risk Score in Acute Coronary Syndromes

Cited by 56 publications

References 11 publications

Serum Amyloid A is a Better Predictor of Clinical Outcomes than C-Reactive Protein in Non-ST-Segment Elevation Acute Coronary Syndromes

Serum Amyloid A is a Better Predictor of Clinical Outcomes than C-Reactive Protein in Non-ST-Segment Elevation Acute Coronary Syndromes

Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

Biomarkers on Admission for the Prediction of Cardiovascular Events After Primary Stenting in Patients with ST‐Elevation Myocardial Infarction

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