title: Usefulness of C-reactive protein as a marker of early post-infarct left ventricular systolic dysfunction.
abstract: OBJECTIVE
  To assess the usefulness of in-hospital measurement of C-reactive protein (CRP) concentration in comparison to well-established risk factors as a marker of post-infarct left ventricular systolic dysfunction (LVSD) at discharge.
  
  
  METHODS
  Two hundred and four consecutive patients with ST-segment-elevation myocardial infarction (STEMI) were prospectively enrolled into the study. CRP plasma concentrations were measured before reperfusion, 24 h after admission and at discharge with an ultra-sensitive latex immunoassay.
  
  
  RESULTS
  CRP concentration increased significantly during the first 24 h of hospitalization (2.4 ± 1.9 vs. 15.7 ± 17.0 mg/L; p < 0.001) and persisted elevated at discharge (14.7 ± 14.7 mg/L), mainly in 57 patients with LVSD (2.4 ± 1.8 vs. 25.0 ± 23.4 mg/L; p < 0.001; CRP at discharge 21.9 ± 18.6 mg/L). The prevalence of LVSD was significantly increased across increasing tertiles of CRP concentration both at 24 h after admission (13.2 vs. 19.1 vs. 51.5 %; p < 0.0001) and at discharge (14.7 vs. 23.5 vs. 45.6 %; p < 0.0001). Multivariate analysis demonstrated CRP concentration at discharge to be an independent marker of early LVSD (odds ratio of 1.38 for a 10 mg/L increase, 95 % confidence interval 1.01-1.87; p < 0.04).
  
  
  CONCLUSIONS
  Measurement of CRP plasma concentration at discharge may be useful as a marker of early LVSD in patients after a first STEMI.
authors.affiliation: Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland. i.swiat@wp.pl
authors.forename: Iwona
authors.initials: I
authors.lastname: Swiatkiewicz
authors.forename: Marek
authors.initials: M
authors.lastname: Kozinski
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Magielski
authors.forename: Joanna
authors.initials: J
authors.lastname: Gierach
authors.forename: Tomasz
authors.initials: T
authors.lastname: Fabiszak
authors.forename: Aldona
authors.initials: A
authors.lastname: Kubica
authors.forename: Adam
authors.initials: A
authors.lastname: Sukiennik
authors.forename: Eliano Pio
authors.initials: EP
authors.lastname: Navarese
authors.forename: Grazyna
authors.initials: G
authors.lastname: Odrowaz-Sypniewska
authors.forename: Jacek
authors.initials: J
authors.lastname: Kubica
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D000077144:Clopidogrel; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D020913:Perindopril / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D002097:C-Reactive Protein; D000077144:Clopidogrel; D008790:Metoprolol; D013988:Ticlopidine; D001241:Aspirin; D020913:Perindopril