title: Association between electrocardiographic pattern and level of C-reactive protein in patients with first anterior wall acute myocardial infarction.
abstract: 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.
authors.affiliation: Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Adlery@yahoo.com
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Adler
authors.forename: Italy
authors.initials: I
authors.lastname: Wiser
authors.forename: Mordehay
authors.initials: M
authors.lastname: Vaturi
authors.forename: Malka
authors.initials: M
authors.lastname: Kahana-Duczyminer
authors.forename: Noam
authors.initials: N
authors.lastname: Fink
authors.forename: Yochai
authors.initials: Y
authors.lastname: Birnbaum
authors.forename: Boris
authors.initials: B
authors.lastname: Strasberg
mesh_terms: 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
chemical_list: D002097:C-Reactive Protein