Predictive value of C-reactive protein and left ventricular diastolic filling pattern after a non-ST elevation myocardial infarction.
BACKGROUND
Recent studies have shown that the odds ratio for high-sensitivity C-reactive protein (CRP) in predicting a coronary events in healthy subjects is 1.4, a value substantially less than previously reported. It is unclear whether this extends to acute coronary syndrome patients or if CRP would predict long-term events in this population. We evaluated the predictive value of CRP in patients with non-ST segment elevation myocardial infarction (NSTEMI) as their first manifestation of coronary artery disease and compared it with that of left ventricle diastolic function.


METHODS
Serum CRP concentration measurement and left ventricle diastolic function evaluation were performed in 51 consecutive patients with NSTEMI 48 hours, 3 months, and 6 months after infarction. Patients were followed for 1 year and events comprising the endpoints of death, new myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting were reported.


RESULTS
Thirty of 51 patients developed the endpoints. Mean CRP concentration in patients who developed any endpoint and those who did not was similar at 48 hours, 3 months, and 6 months. A strong correlation between the presence of impaired relaxation 6 months after the infarction and development of the combined endpoints was noted (P < 0.001).


CONCLUSIONS
CRP has limited value in predicting future cardiovascular events in subjects with NSTEMI. Other biomarkers or a combination of other biomarkers may be needed to identify patients at high risk. Evaluation of diastolic left ventricular function not during the acute phase but 6 months later could predict adverse outcome in our series.
Zacharoulis
Achilles
A
Cardiology Department, Athens General Hospital G. Genimmatas, Athens, Greece. aazacha@hotmail.com
Kotseroglou
Vasiliki
V
Lerakis
Stamatios
S
Karavidas
Apostolos
A
Arapi
Sophia
S
Zacharoulis
Apostolos
A
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease; D003643:Death; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers; D002097:C-Reactive Protein