title: Concomitant impact of high-sensitivity C-reactive protein and renal dysfunction in patients with acute myocardial infarction.
abstract: OBJECTIVE
  The present study aimed to investigate the impact of high-sensitivity C-reactive protein (hs-CRP) and renal dysfunction on clinical outcomes in acute myocardial infarction (AMI) patients.
  
  
  METHODS
  The study involved a retrospective cohort of 8332 patients admitted with AMI. The participants were divided into 4 groups according to the levels of estimated glomerular filtration rate (eGFR) and hs-CRP: group I, no renal dysfunction (eGFR ≥60 mL·min(-1)·1.73 m(-2)) with low hs-CRP (≤2.0 mg/dL); group II, no renal dysfunction with high hs-CRP; group III, renal dysfunction with low hs-CRP; and group IV, renal dysfunction with high hs-CRP. We compared major adverse cardiac events (MACE) over a 1-year follow-up period.
  
  
  RESULTS
  The 4 groups demonstrated a graded association with increased MACE rates (group I, 8.8%; group II, 13.8%; group III, 18.6%; group IV, 30.1%; p<0.001). In a Cox proportional hazards model, mortality at 12 months increased in groups II, III, and IV compared with group I [hazard ratio (HR) 2.038, 95% confidence interval (CI) 1.450-2.863, p<0.001; HR 3.003, 95% CI 2.269-3.974, p<0.001; HR 5.087, 95% CI 3.755-6.891, p<0.001].
  
  
  CONCLUSIONS
  High hs-CRP, especially in association with renal dysfunction, is related to the occurrence of composite MACE, and indicates poor prognosis in AMI patients.
authors: Department of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Gwangju 501-757, Korea. skimw@chonnam.ac.kr.
authors: Yong Un
authors: YU
authors: Kang
authors: Min Jee
authors: MJ
authors: Kim
authors: Joon Seok
authors: JS
authors: Choi
authors: Chang Seong
authors: CS
authors: Kim
authors: Eun Hui
authors: EH
authors: Bae
authors: Seong Kwon
authors: SK
authors: Ma
authors: Young-Keun
authors: YK
authors: Ahn
authors: Myung Ho
authors: MH
authors: Jeong
authors: Young Jo
authors: YJ
authors: Kim
authors: Myeong Chan
authors: MC
authors: Cho
authors: Chong Jin
authors: CJ
authors: Kim
authors: Soo Wan
authors: SW
authors: Kim
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; glomerular filtration rate; myocardial infarction