title: Predictive value of basal C-reactive protein levels for myocardial salvage in patients with acute myocardial infarction is dependent on the type of reperfusion treatment.
abstract: OBJECTIVE
  To evaluate whether C-reactive protein (CRP) levels on admission are predictive of myocardial salvage achieved with different reperfusion strategies in patients with acute myocardial infarction (AMI).
  
  
  RESULTS
  Patients with AMI treated with stenting plus abciximab (n=125) and thrombolysis alone (n=54) or with abciximab (n=71) were prospectively studied. CRP levels were measured by a high sensitivity assay. The threshold of the upper quartile (12 mg/l) was used to divide patients into two groups: 60 patients with high CRP (>12 mg/l) and 190 patients with low CRP (< or =12 mg/l). Myocardial salvage was measured by technetium (Tc)-99(m)sestamibi scintigraphy. Patients in the high CRP group had a significantly lower salvage index (0.35+/-0.42 vs 0.48+/-0.34, p=0.01) and higher 18-month mortality (11.7 vs 3.2%, p=0.03) compared to those in the low CRP group. While basal CRP was not related to myocardial salvage in patients treated with stenting plus abciximab (p=0.89) or thrombolysis plus abciximab (p=0.43), a high CRP on admission was associated with a significantly lower salvage index (0.09+/-0.48 vs 0.42+/-0.37 in the low CRP group, p=0.006) among patients treated with thrombolysis alone.
  
  
  CONCLUSIONS
  CRP levels on admission may predict the efficacy of reperfusion in patients with AMI. The predictive ability is dependent on the form of reperfusion therapy.
authors.affiliation: Deutsches Herzzentrum, Technische Universität München, Munich, Germany.
authors.forename: Alban
authors.initials: A
authors.lastname: Dibra
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.forename: Helmut
authors.initials: H
authors.lastname: Schühlen
authors.forename: Hildegard
authors.initials: H
authors.lastname: Bollwein
authors.forename: Siegmund
authors.initials: S
authors.lastname: Braun
authors.forename: Jodi
authors.initials: J
authors.lastname: Neverve
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D016879:Salvage Therapy / Q000379:methods; D015607:Stents; D016019:Survival Analysis; D017256:Technetium Tc 99m Sestamibi; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019275:Radiopharmaceuticals; D002097:C-Reactive Protein; D017256:Technetium Tc 99m Sestamibi; D000077284:Abciximab