Early use of beta-blockers is associated with attenuation of serum C-reactive protein elevation and favorable short-term prognosis after acute myocardial infarction.
BACKGROUND
We have reported that a marked elevation in serum C-reactive protein (CRP) level is a predictor for infarct expansion and cardiac rupture after AMI. Although beta-blockers prevent cardiac rupture after AMI, their effect on serum CRP elevation has not been determined.


METHODS
We studied a total of 154 patients with first Q-wave AMI. Patients complicated by pump failure were excluded from this study. Eighty-two patients received beta-blocker treatment within 24 h of the onset of AMI, while 72 patients received no beta-blocker treatment. Peak serum creatine kinase (CK) and CRP levels were determined by serial measurements.


RESULTS
There was no difference between the groups according to age, sex, coronary risk factors, pre-infarction angina, infarct site, prior use of cardiovascular drugs, use of revascularization therapy, and prevalence of multivessel disease. Beta-blocker treatment was associated with a lower peak CRP level (6.9 +/- 6.1 vs.10.8 +/- 9.3 mg/dl, p = 0.002), a shorter duration from the onset to the peak CRP level (2 +/- 1 vs. 3 +/- 2 days, p < 0.0001), a lower incidence of cardiac rupture (p = 0.03) and lower in-hospital cardiac mortality (p = 0.02), despite similar peak CK levels.


CONCLUSIONS
The early use of beta-blockers is associated with decreased serum CRP level and a favorable clinical outcome after first Q-wave AMI, suggesting some beneficial effects of beta-blockers on infarct healing after AMI.
Anzai
Toshihisa
T
Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan. anzai@cpnet.med.keio.ac.jp
Yoshikawa
Tsutomu
T
Takahashi
Toshiyuki
T
Maekawa
Yuichiro
Y
Okabe
Teruo
T
Asakura
Yasushi
Y
Satoh
Toru
T
Mitamura
Hideo
H
Ogawa
Satoshi
S
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D016207:Cytokines / Q000097:blood; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000517:prevention & control; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy*; D011379:Prognosis
D000319:Adrenergic beta-Antagonists; D016207:Cytokines; D002097:C-Reactive Protein