title: Prognostic value of C-reactive protein and cardiac troponin I in primary percutaneous interventions for ST-elevation myocardial infarction.
abstract: BACKGROUND
  The rise in cardiac troponin I after ST-elevation myocardial infarction treated by primary percutaneous coronary interventions (PCIs) is predictive of infarct size and left ventricular ejection fraction (LVEF). However, the comparative value of C-reactive protein (CRP) and troponin I for infarct size evaluation and the respective relationships between these biomarkers and mortality have not been investigated.
  
  
  METHODS
  We studied 87 patients who underwent primary PCI for ST-elevation myocardial infarction. Concentrations of troponin I and CRP were measured before and for 72 hours after PCI. Infarct size was measured by the cumulative release of alpha-hydroxybutyrate deshydrogenase during the 72 hours after PCI (QHBDH72) and by delayed radionuclide LVEF (at 4.6 +/- 1.7 weeks).
  
  
  RESULTS
  Concentrations of CRP at peak and at 24, 48 and 72 hours, and of troponin I at 6 and 72 hours, correlated with QHBDH72 and LVEF. In single variable analysis, at a mean follow-up of 42 +/- 8 months, Killip score of 3 to 4, CRP at baseline and at 48 hours, and troponin I at 6 and 72 hours were related to mortality. By multiple variable analysis, Killip score (OR 9.9, CI 1.6-58.8) and troponin I at 72 hours (OR 9.43, CI 2.1-43.5) were the only independent predictors of mortality.
  
  
  CONCLUSIONS
  Plasma concentrations of CRP and troponin I after PCI were related to infarct size and mortality. However, Killip class and troponin I at 72 hours were the only independent predictors of mortality at long-term follow-up.
authors.affiliation: Department of Cardiology, Hospital of Mulhouse, 68070 Mulhouse Cedex, France. patrick.ohlmann@chru-strasbourg.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Ohlmann
authors.forename: Laurent
authors.initials: L
authors.lastname: Jaquemin
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.forename: Rachid
authors.initials: R
authors.lastname: El Behlgiti
authors.forename: Antoine
authors.initials: A
authors.lastname: Faure
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Michotey
authors.forename: Nathalie
authors.initials: N
authors.lastname: Beranger
authors.forename: Gerald
authors.initials: G
authors.lastname: Roul
authors.forename: Francis
authors.initials: F
authors.lastname: Schneider
authors.forename: Pierce
authors.initials: P
authors.lastname: Bareiss
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Monassier
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006884:Hydroxybutyrate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000378:metabolism*; D009994:Osmolar Concentration; D011237:Predictive Value of Tests; D011379:Prognosis; D015635:Radionuclide Ventriculography; D015607:Stents / Q000009:adverse effects; D013318:Stroke Volume; D013997:Time Factors; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I; D002097:C-Reactive Protein; D006884:Hydroxybutyrate Dehydrogenase