title: Comparison of C-reactive protein and fibrinogen levels in patients having anterior wall ST-Segment elevation myocardial infarction with versus without left ventricular thrombus (from a primary percutaneous coronary intervention cohort).
abstract: We tested the hypothesis that admission serum inflammatory biomarkers may predict risk of early left ventricular (LV) thrombus formation in patients with first-ever anterior wall ST-segment elevation myocardial infarction (STEMI). Medical records of 207 patients admitted to our department between January 2006 and April 2012 for first-ever diagnosed anterior wall STEMI and treated with primary percutaneous coronary intervention (PPCI) were reviewed. Serum C-reactive protein (CRP) and fibrinogen levels were determined from blood samples taken before PPCI. Patients underwent an initial cardiac echocardiography on days 1 or 2 of admission and a second echocardiography on days 5 to 7 of hospitalization. An early LV thrombus was detected on the second echocardiogram in 11 patients (11 of 207, 5%), 6 of whom had also displayed an LV thrombus already during their first echocardiogram. Patients with an LV thrombus had significantly higher mean serum CRP levels than those without an LV thrombus (48 mg/L vs 8.4 mg/L, p = 0.001), and a trend for higher fibrinogen levels was also observed (398 ± 135 mg/dl vs 312 ± 82 mg/dl, p = 0.063). Following adjustment to other variables and the performance of multiple logistic regression, the CRP (relative risk 4.63, p = 0.004) and fibrinogen (relative risk 1.006, p = 0.033) levels were independent predictors of LV thrombus formation. We conclude that admission serum CRP and fibrinogen levels are independent predictors for early LV thrombus formation complicating a first-ever anterior wall STEMI.
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. kobyshacham@gmail.com
authors.forename: Yacov
authors.initials: Y
authors.lastname: Shacham
authors.forename: Eran
authors.initials: E
authors.lastname: Leshem-Rubinow
authors.forename: Eyal
authors.initials: E
authors.lastname: Ben Assa
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.forename: Yan
authors.initials: Y
authors.lastname: Topilsky
authors.forename: Arie
authors.initials: A
authors.lastname: Roth
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056988:Anterior Wall Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D003328:Coronary Thrombosis / Q000097:blood*; D004452:Echocardiography; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006352:Heart Ventricles; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein