[Independent role of C reactive protein to predict major events at one-month and at one-year in acute coronary syndrome without ST elevation].
OBJECTIVE
We intended to determine whether C-reactive protein (CRP) provides independent prognostic information after a non-ST elevation acute coronary syndrome.


METHODS
We prospectively studied 630 consecutive patients admitted with a diagnosis of non-ST elevation acute coronary syndrome. Cut-off values were: troponin I > 1 ng/ml (n = 354; 56%) and CRP > 11 mg/l (n = 273; 43%).


RESULTS
Within a one-year follow-up period, 56 (9%) cardiac deaths, 85 (13%) myocardial infarctions (MI) and 127 (20%) first major events were detected. Patients with increased CRP showed higher rates of death at one-month (8% vs 1%), death at one-year (15% vs 4%), myocardial infarction at one-month (8% vs 4%), myocardial infarction at one-year (19% vs 9%), major events at one-month (15% vs 5%) and major events at one-year (30% vs 13%). In the multivariate analysis, once adjusted for baseline and electrocardiogram data and for myocardial damage markers, CRP was an independent predictor of death at one-month (odds ratio [OR] 4.6) and death at one-year (OR = 2.7), major events at one-month (OR = 1.8) and major events at one-year (OR = 1.8). Troponin I predicted MI at one-month (OR = 2.5) and MI at one-year (OR = 2.2).


CONCLUSIONS
CRP provided independent information to predict major events in non-ST elevation acute coronary syndromes. Troponin I was a more powerful predictor of MI than PCR. The analysis of CRP and myocardial damage markers in the short-term and long-term risk stratification seems worthy.
Bodí
Vicent
V
Servicio de Cardiología, Hospital Clínico y Universitario, Universidad de Valencia, Spain. vicentbodi@hotmail.com
Sanchis
Juan
J
Llàcer
Angel
A
Fácila
Lorenzo
L
Núñez
Julio
J
Pellicer
Mauricio
M
Bertomeu
Vicente
V
Ruiz
Vicente
V
García
Diego
D
Chorro
Francisco J
FJ
D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis* / Q000401:mortality; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013577:Syndrome; D013997:Time Factors; D019210:Troponin I / Q000032:analysis
D015415:Biomarkers; D019210:Troponin I; D002097:C-Reactive Protein