title: Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure.
abstract: 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.
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University, 1200 Main St. W., HSC 2N52, Hamilton, ON, Canada L8N 3Z5. kavsakp@mcmaster.ca
authors.forename: Peter A
authors.initials: PA
authors.lastname: Kavsak
authors.forename: Andrew R
authors.initials: AR
authors.lastname: MacRae
authors.forename: Alice M
authors.initials: AM
authors.lastname: Newman
authors.forename: Viliam
authors.initials: V
authors.lastname: Lustig
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Palomaki
authors.forename: Dennis T
authors.initials: DT
authors.lastname: Ko
authors.forename: Jack V
authors.initials: JV
authors.lastname: Tu
authors.forename: Allan S
authors.initials: AS
authors.lastname: Jaffe
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein