[C-reactive protein (CRP) after revascularized STEMI: is CRP a prognostic factor?].
OBJECTIVE
During myocardial infarction (MI), numerous biomarkers increase, such as troponin (necrosis), BNP, and high sensibility C-reactive protein (hsCRP) (inflammation). The objectives of the study were to study kinetics of hsCRP after a revascularized MI, and correlations between hsCRP and clinical outcomes or biological markers, and prognostic value of CRP.


METHODS
Fifty-two patients were admitted for STEMI (ST segment Elevation MI). Primary coronarography interventions (PCI) were performed for urgent reperfusion. Patients were included only in case of success (TIMI 3). Clinical examination was completed by a biological follow-up of BNP, troponin-I (before and after PCI, days 1, 2, 3, 6) and hsCRP (days 0, 1, 2, 3, 6). Clinical outcomes follow-up was performed during hospitalization, on the first month, and the sixth month.


RESULTS
hsCRP increases during the first days (peak on day 3: 46.1mg/L), and decreases between the third and the seventh day. Clinical outcomes were correlated with CRP: door-to-balloon time, age, creatinin level on admission. During follow-up, there were clinical events in 13/49 (26%) of the patients. Among them, hsCRP on day 2 was higher (p < 0.0001), compared to other patients. Compared to other biological markers, hsCRP was correlated with BNP on days 2 and 3 (p = 0.008).


CONCLUSIONS
hsCRP increases after revascularized STEMI, in accordance to the infarct size, in the first days. hsCRP is correlated with cardiovascular pronostic biomarkers. hsCRP could play an active role, and could be used as a pronostic biomarker after revascularized STEMI, which are usually considered as a low-risk population.
Roubille
F
F
Département de cardiologie, CHU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34000 Montpellier, France. francois.roubille@orange.fr
Cayla
G
G
Picot
M-C
MC
Pradet
V
V
Massin
F
F
Gervasoni
R
R
Pasquie
J-L
JL
Macia
J-C
JC
Piot
C
C
Leclercq
F
F
D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000601:surgery*; D015425:Myocardial Reperfusion; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D014336:Troponin / Q000097:blood
D014336:Troponin; D002097:C-Reactive Protein