title: [The significance of admission hs-CRP in patients undergoing primary percutaneous intervention for acute myocardial infarction].
abstract: OBJECTIVE
  We evaluated the role of admission high-sensitivity C-reactive protein (hs-CRP) level in estimating myocardial perfusion and in-hospital adverse events in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  The study included 43 consecutive patients (34 males, 9 females; mean age 59+/-11 years) who underwent PCI for STEMI within six hours after the onset of symptoms. Coronary angiograms were evaluated with respect to TIMI flow grade, corrected TIMI frame count, and myocardial blush grade (MBG). Electrocardiograms obtained 90 min after PCI were analyzed for ST-segment resolution. In-hospital adverse events were recorded. hs-CRP level was measured by immunonephelometry in blood obtained immediately before PCI.
  
  
  RESULTS
  The mean hs-CRP level was 1.35+/-1.17 mg/dl. Based on the median hs-CRP value (0.98 mg/dl), 22 patients with a low hs-CRP level had a lower frequency of hypertension (p=0.047), decreased TIMI frame counts of the left anterior descending (p=0.010) and circumflex (p=0.033) arteries, a higher rate of ST resolution (p=0.000), improved MBG (p=0.015), and shorter hospitalization (p=0.028). Adverse events occurred in six patients (14%), in five of whom (5/21) the hs-CRP level was above 0.98 mg/dl. hs-CRP was significantly correlated with corrected TIMI frame counts of the left anterior descending (r=0.388, p=0.01) and circumflex arteries (r=0.336, p=0.027), length of hospitalization (r=0.357, p=0.019), and inversely correlated with MBG (r=-0.415, p=0.006). In multivariate regression analysis, hs-CRP was found to be an independent predictor of ST resolution (p=0.008). ROC analysis showed that a higher level of hs-CRP than 0.88 mg/dl predicted poor MBG with 73% sensitivity and 31% specificity (95% CI 0.577-0.899, p=0.01).
  
  
  CONCLUSIONS
  In STEMI patients undergoing primary PCI, high levels of admission hs-CRP are associated with poor myocardial perfusion and longer hospitalization.
authors.affiliation: Türkiye Yüksek Ihtisas Eğitim ve Araştirma Hastanesi Kardiyoloji Kliniği, Ankara, Turkey. kumralcagli@yahoo.com
authors.forename: Kumral Ergün
authors.initials: KE
authors.lastname: Cağli
authors.forename: Serkan
authors.initials: S
authors.lastname: Topaloğlu
authors.forename: Dursun
authors.initials: D
authors.lastname: Aras
authors.forename: Emre Nuri
authors.initials: EN
authors.lastname: Günel
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Ozlü
authors.forename: Belma
authors.initials: B
authors.lastname: Uygur
authors.forename: Erkan
authors.initials: E
authors.lastname: Baysal
authors.forename: Nihat
authors.initials: N
authors.lastname: Sen
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D009391:Nephelometry and Turbidimetry / Q000379:methods; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity
chemical_list: D002097:C-Reactive Protein