C-reactive protein levels on admission are associated with response to thrombolysis and prognosis after ST-segment elevation acute myocardial infarction.
BACKGROUND
Several studies have shown the independent association of high plasma C-reactive protein (CRP) levels with an adverse prognosis in patients with acute myocardial infarction. However, the possible association of plasma CRP levels with response to thrombolysis and short- and long-term cardiac mortality has not been investigated. The aim of this study was to evaluate these possible associations.


METHODS
Three hundred nineteen consecutive patients who received intravenous thrombolysis because of ST-segment elevation acute myocardial infarction were prospectively studied. Patients were classified according to tertiles of plasma CRP levels on admission.


RESULTS
Patients at the top tertile had a significantly lower incidence of complete ST-segment resolution (third vs first, P <.001, third vs second, P =.009) or Thrombolysis In Myocardial Infarction (TIMI) 3 flow in the infraction-related artery (third vs first, P <.001, third vs second, P =.02), more compromised left ventricular function (third vs first, P =.02, second vs third, P =.04), greater inhospital mortality (third vs first, P =.03, third vs second, P =.06), and greater 3-year cardiac mortality (third vs first, P =.01, third vs second, P =.07).


CONCLUSIONS
Plasma levels of CRP on admission may be a predictor of reperfusion failure and of short- and long-term prognosis in patients with ST-segment elevation acute myocardial infarction.
Zairis
Michael N
MN
Department of Cardiology, Tzanio Hospital, Piraeus, Greece. zairis@hellasnet.gr
Manousakis
Stavros J
SJ
Stefanidis
Alexander S
AS
Papadaki
Olga A
OA
Andrikopoulos
George K
GK
Olympios
Christopher D
CD
Hadjissavas
John J
JJ
Argyrakis
Spyros K
SK
Foussas
Stefanos G
SG
D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D017211:Treatment Failure
D015415:Biomarkers; D002097:C-Reactive Protein