C-Reactive protein as a risk factor for left ventricular thrombus in patients with acute myocardial infarction.
BACKGROUND
Elevated C-reactive protein (CRP) has been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that CRP may be involved in initiation process of coagulation; however, the role of CRP level in the formation of left ventricular (LV) thrombus has not been studied.


OBJECTIVE
This study investigated whether CRP is a risk factor for LV thrombus in patients with AMI.


METHODS
Clinical, echocardiographic, and biochemical data were analyzed in 141 consecutive patients (aged 57 +/- 13 years; 33 women) with first anterior AMI. Two-dimensional and Doppler echocardiographic examinations were performed on Days 1, 3, 7, 15, and 30. Blood samples were obtained every day during hospitalization. Serum CRP concentrations were measured by an ultrasensitive immunonephelometry method.


RESULTS
Left ventricular thrombus was detected in 33 (23.4%) patients. Univariate analysis showed that patients with LV thrombus had a higher peak creatine kinase (CK) level (2,879 +/- 742 vs. 1,693 +/- 1,210 I/U, p = 0.001), higher peak CRP level (14.9 +/- 7.1 vs. 9.2 +/- 6.8 mg/dl, p = 0.001), higher wall motion score index (1.8 +/- 0.2 vs. 1.5 +/- 0.3, p = 0.002), higher apical wall motion score index (2.35 +/- 0.72 vs. 2.07 +/- 0.70, p = 0.001), larger end-diastolic volume (145.2 +/- 43.7 vs. 116.5 +/- 44.2 ml, p = 0.002), larger end-systolic volume (85.4 +/- 37.2 vs. 62.9 +/- 31.6 ml, p = 0.003), and lower ejection fraction (42.1 +/- 12 vs. 47.3 +/- 13, p = 0.04). In multivariate analyses, only peak CK level (p = 0.0001), LV apical wall motion score index (p = 0.001), and CRP levels (p = 0.001) were independent predictors of LV thrombus formation.


CONCLUSIONS
These results suggest that CRP is a risk factor for LV thrombus in patients with AMI.
Celik
S
S
KTU Faculty of Medicine, Department of Cardiology, Trabzon, Turkey. ercevdet@usa.net
Baykan
M
M
Erdöl
C
C
Kilinç
K
K
Orem
A
A
Orem
C
C
Durmus
I
I
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications*
D008055:Lipids; D002097:C-Reactive Protein; D003402:Creatine Kinase