title: Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention.
abstract: OBJECTIVE
  To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI.
  
  
  RESULTS
  We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with STEMI onset <12 h and hs-C-reactive protein determination on admission. Patients were classified into four groups [I (hs-C-reactive protein < 0.48 mg/dL), II (hs-C-reactive protein > or = 0.48 to <1.2 mg/dL), III (hs-C-reactive protein > or = 1.2 to <3.1 mg/dL), IV (hs-C-reactive protein > or = 3.1 mg/dL)] according to quartiles of hs-C-reactive protein serum level. The IV quartile hs-C-reactive protein group had a higher incidence of in-hospital mortality and cumulative adverse events. At a mean follow-up of 724 +/- 376 days (range 0-1393), the IV quartile hs-C-reactive protein group showed lower estimated survival, lower estimated myocardial infarction-free survival and lower estimated event-free survival. At multivariable analysis hs-C-reactive protein appeared to be an independent predictor of long-term mortality (HR: 1.04, 95% CI: 1.01-1.07, P = 0.003), long-term mortality and re-infarction (HR: 1.03, 95% CI: 1.01-1.06, P = 0.008) and adverse events (HR: 1.03, 95% CI: 1.01-1.05, P = 0.03).
  
  
  CONCLUSIONS
  Evaluation of hs-C-reactive protein on admission in STEMI patients undergoing primary PCI allows reliable risk stratification of these patients.
authors.affiliation: Institute of Cardiology, Azienda Ospedaliera S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna 40138, Italy. paortol@tin.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Ortolani
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Marrozzini
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Francesco
authors.initials: F
authors.lastname: Saia
authors.forename: Nevio
authors.initials: N
authors.lastname: Taglieri
authors.forename: Federica
authors.initials: F
authors.lastname: Baldazzi
authors.forename: Simona
authors.initials: S
authors.lastname: Silenzi
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Bacchi-Reggiani
authors.forename: Paolo
authors.initials: P
authors.lastname: Guastaroba
authors.forename: Roberto
authors.initials: R
authors.lastname: Grilli
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein