Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention

Ortolani, Paolo; Marzocchi, Antonío; Marrozzini, Cinzia; Palmerini, Tullio; Saia, Francesco; Taglieri, Nevio; Baldazzi, Federica; Silenzi, Simona; Reggiani, Maria Letizia Bacchi; Guastaroba, Paolo; Grilli, Roberto; Branzi, Angelo

doi:10.1093/eurheartj/ehm338

Cited by 47 publications

(47 citation statements)

References 23 publications

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“…Of the studied biochemical indicators, NT-proBNP, CRP, and troponin I have been broadly validated earlier as postinfarct prognosticators -each representing a different component of the pathophysiologic milieu contributing to the unfavorable alterations in the infarcted heart [2][3][4][5][18][19][20][21][22]. Somewhat unexpectedly, other biomarkers were superior to NT-proBNP in predicting the aggravation of LV function as assessed by echocardiography; however, the analysis of heart failure deterioration requiring hospital admission and the composite of cardiac events corroborated the clinical significance of this peptide.…”

Section: Discussionmentioning

confidence: 99%

Prediction of left ventricular dysfunction progression in patients with a first ST-elevation myocardial infarction – contribution of cystatin C assessment

Derzhko

Płaksej²,

Przewlocka‐Kosmala³

et al. 2009

Coronary Artery Disease

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Section: Discussionmentioning

confidence: 99%

Prediction of left ventricular dysfunction progression in patients with a first ST-elevation myocardial infarction – contribution of cystatin C assessment

Derzhko

Płaksej²,

Przewlocka‐Kosmala³

et al. 2009

Coronary Artery Disease

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“…1 In recent years, increasing data have demonstrated a clear relationship between elevated inflammatory biomarkers and the risk of future atherothrombotic events in multiple clinical settings. [2][3][4][5][6][7] However, little is known about whether and how biomarkers should be used to adjust medical therapy in patients with coronary atherosclerosis. Only the Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial 8 has shown a clinical benefit to therapy based on an inflammatory biomarker.…”

mentioning

confidence: 99%

Relationship Between Baseline Inflammatory Markers, Antiplatelet Therapy, and Adverse Cardiac Events After Percutaneous Coronary Intervention

Dosh

Berger

Marso

et al. 2009

Circ: Cardiovascular Interventions

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Background-We evaluated patients undergoing percutaneous coronary intervention to assess the predictive value of high-sensitivity C-reactive protein (hs-CRP) and pregnancy-associated plasma protein-A (PAPP-A) on adverse cardiac outcomes and the effect of antiplatelet therapy on these outcomes. Methods and Results-Baseline blood samples were available on 1468 CREDO (Clopidogrel for the Reduction of Events During Observation) patients for hs-CRP testing and 1096 patients for PAPP-A testing. The 1-year primary end point was the composite incidence of death, myocardial infarction, or stroke. Patients in the highest 2 tertiles of hs-CRP had more events compared with the lowest tertile (11.4% versus 6.4%, Pϭ0.003). Treatment with clopidogrel reduced the 1-year composite end point for patients in the highest 2 tertiles of hs-CRP (9.1% clopidogrel versus 13.5% placebo, Pϭ0.04) but not in the lowest tertile. Elevated PAPP-A levels were associated with a trend toward more events at 1 year that did not reach statistical significance. Patients in the highest 2 tertiles of PAPP-A randomized to clopidogrel had fewer events (7.3% clopidogrel versus 13.1% placebo, Pϭ0.01), but no benefit was seen in the lowest tertile. A 46% risk reduction with randomization to clopidogrel was seen in patients in the highest 2 tertiles of both biomarkers (8.7% versus 16.2%, Pϭ0.02). Conclusions-Patients

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“…In an Italian cohort comprising 758 patients, hs-CRP was associated with short-term mortality, long-term death, AMI and target-vessel revascularization 33 . This was also a retrospective study and was associated with a high rate of patient exclusion from the cohort (22% of the initial sample) because of the lack of CRP data on admission .…”

Section: Discussionmentioning

confidence: 99%

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

Ribeiro¹,

Ramos²,

Vieira³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundThe association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.ObjectiveTo investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.MethodsThis prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating 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 patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.ResultsThe mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently 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.ConclusionAlthough high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.

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Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention

Abstract: Evaluation of hs-C-reactive protein on admission in STEMI patients undergoing primary PCI allows reliable risk stratification of these patients.

Cited by 47 publications

References 23 publications

Prediction of left ventricular dysfunction progression in patients with a first ST-elevation myocardial infarction – contribution of cystatin C assessment

Prediction of left ventricular dysfunction progression in patients with a first ST-elevation myocardial infarction – contribution of cystatin C assessment

Relationship Between Baseline Inflammatory Markers, Antiplatelet Therapy, and Adverse Cardiac Events After Percutaneous Coronary Intervention

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

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