Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure.
OBJECTIVE
To assess the ability of C-reactive protein (CRP) to predict long-term outcomes in a chest pain population.


METHODS
CRP was measured at presentation in 446 emergency department patients with acute coronary syndromes. All-cause mortality and hospital discharges for acute myocardial infarction (AMI) and congestive heart failure (CHF) were obtained for up to 8 years following the event.


RESULTS
Kaplan-Meier analyses indicated that patients with CRP concentrations above the American Heart Association scientific statement cut-off had a higher rate for death and CHF admissions. After adjusting for troponin concentrations, in a Cox proportional hazard model, only CRP concentrations indicative of an acute phase response (i.e., >7.44 mg/L) were associated with a significant risk for death after 5 years and CHF readmission after 2 years.


CONCLUSIONS
Patients presenting early with chest pain with elevated CRP concentrations have a greater long-term risk for death and heart failure.
Kavsak
Peter A
PA
Department of Pathology and Molecular Medicine, McMaster University, 1200 Main St. W., HSC 2N52, Hamilton, ON, Canada L8N 3Z5. kavsakp@mcmaster.ca
MacRae
Andrew R
AR
Newman
Alice M
AM
Lustig
Viliam
V
Palomaki
Glenn E
GE
Ko
Dennis T
DT
Tu
Jack V
JV
Jaffe
Allan S
AS
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000378:metabolism / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000378:metabolism / Q000401:mortality; D016016:Proportional Hazards Models; D015996:Survival Rate
D015415:Biomarkers; D002097:C-Reactive Protein