Association between electrocardiographic pattern and level of C-reactive protein in patients with first anterior wall acute myocardial infarction.
BACKGROUND
Studies of prognostic markers after first anterior wall acute myocardial infarction (AMI) have reported an association between persistent ST segment elevation on the electrocardiogram (ECG) and increased levels of C-reactive protein (CRP) and worse outcome. The aim of the present study was to determine the nature of the relationship between these two factors.


METHODS
Twenty-three consecutive patients admitted with AMI underwent 12-lead ECG on days 1, 2, 3 and 7 and were classified into two groups according to the findings on each day's recording: pattern A - isoelectric ST segment, or pattern B - ST segment elevation with or without a negative T wave. Serum CRP levels measured on the same days were also compared between the groups.


RESULTS
The number of patients classified as pattern A increased over time, from 8 on day 1 after AMI to 11 on day 2, 12 on day 3 and 14 on day 7, with a corresponding decrease in pattern B patients. Most of the patients with pattern B on day 1 showed a persistent pattern on day 7. For each day studied, the pattern A and pattern B patients showed a statistically significant difference in serum CRP levels on the second and third days after AMI, respectively. Values for the day 7 groups were: 3.1 +/- 3.4 versus 9.6 +/- 3.8 mg% (p = 0.001) (day 2) and 3.1 +/- 1.2 versus 7.9 +/- 3.6 mg% (p = 0.0005) (day 3).


CONCLUSIONS
There was a significant association between high CRP levels on the second and third day following first AMI and ECG pattern B (ST elevation). This conclusion strengthens our earlier findings that pattern B is predictive of poor outcome in this patient population.
Adler
Yehuda
Y
Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Adlery@yahoo.com
Wiser
Italy
I
Vaturi
Mordehay
M
Kahana-Duczyminer
Malka
M
Fink
Noam
N
Birnbaum
Yochai
Y
Strasberg
Boris
B
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D011379:Prognosis; D013997:Time Factors
D002097:C-Reactive Protein