The role of C-reactive protein on the long-term clinical outcome after primary or rescue percutaneous coronary intervention.
BACKGROUND
We examined the clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI) and long-term survival rate after primary or rescue PCI in patients with acute myocardial infarction (AMI) according to the level of the C-Reactive Protein (CRP) on admission.


METHODS
Two hundred and eight consecutive patients with AMI who underwent primary or rescue PCI between 1997 and 1999 at Chonnam National University Hospital were divided into two groups: Group I (n = 86, 59.9 +/- 9.3 years, male 74.4%) with a normal CRP (< 1.0 mg/dL, mean value = 0.43 +/- 0.14 mg/dL) on admission and Group II (n = 122, 59.1 +/- 10.4 years, male 83.6%) with an elevated CRP (> or = 1.0 mg/dL, mean value = 3.50 +/- 0.93 mg/dL) on admission.


RESULTS
There were no significant differences in teh baseline characteristics noted between the two groups. The incidence of cardiogenic shock was higher in Group II than in Group I (Group I; 3/86, 3.5% vs. Group II; 15/122, 12.3%, p = 0.026). The coronary angiographic findings did not differ between the two groups. The ejection fraction and Thrombolysis In Myocardial Infarction flow grade improved after PCI in both groups. The primary success rate of PCI was 94.2% (81/86) in Group I and 95.1% (116/122) in Group II (p = 0.776). The survival rates for Group I were 97.7%, 97.7% and 96.5%, and those for Group II were 91.8%, 91.0% and 86.9% at 1, 6 and 12 months, respectively (p = 0.043 at 1 month, p = 0.040 at 6 months, p = 0.018 at 12 months).


CONCLUSIONS
A high incidence of cardiogenic shock and worse long-term survival after PCI are observed in AMI patients with an elevated CRP.
Hong
Young Joon
YJ
Heart Center of Chonnam National University Hospital, Research Institute of Medical Sciences, Chonnam National University, Gwangju, Korea.
Jeong
Myung Ho
MH
Park
Ok Young
OY
Kim
Weon
W
Kim
Ju Han
JH
Ahn
Young Keun
YK
Cho
Jeong Gwan
JG
Ahn
Byoung Hee
BH
Suh
Soon Pal
SP
Park
Jong Chun
JC
Kim
Sang Hyung
SH
Kang
Jung Chaee
JC
D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D002097:C-Reactive Protein