title: The relationship between C-reactive protein and the lapse of time since the onset of the symptoms after acute myocardial infarction: an prospective-observational study.
abstract: OBJECTIVE
  It is important to know the elapsed symptom-to-door (StD) time between the emergence of ST-elevation myocardial infarction (STEMI) symptoms and admission to the hospital in terms of the selection of appropriate treatment and prognosis. In this study, we aimed to assess the relationship between serum C-reactive protein (CRP) and StD time after STEMI.
  
  
  METHODS
  436 of the patients admitted to our center with STEMI between August 2012-February 2013 (338 male, mean age, 63.9±12.8) were included in this prospective-observational cohort study. Blood samples were obtained from laboratory results of the first reference period. Patients were divided into four groups according to the duration of StD time [0-1. hour; group 1 (G1), 1-3. hour; group 2 (G2), 3-6. hour; group 3 (G3), 6-12. hour; group 4 (G4)]. Statistical analysis was performed via chi-squre test, ANOVA test, Pearson's correlation analysis and receiver operator charecteristic (ROC) analysis.
  
  
  RESULTS
  As the time progressed, an increase in CRP levels was observed. The difference among the means of the G1-G3 (p=0.002), G1-G4 (p<0.001), G2-G4 (p<0.001) and G3-G4 (p<0.001) groups was found to be statistically significant. There was a good correlation between the StD time and CRP levels (r=0.676). ROC analysis of the predictive value of CRP for the third hour was determined as 0.78 mg/dL, respectively (AUC was 0.824; 95% C.I. was 0.785-0.859; 73.9% sensitivity, 78.1% specificity).
  
  
  CONCLUSIONS
  According to serum CRP levels after STEMI at hospital admission, StD time can be estimated.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Şifa University; İzmir-Turkey. drilkergul46@gmail.com.
authors.forename: İlker
authors.initials: İ
authors.lastname: Gül
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.forename: Faruk
authors.initials: F
authors.lastname: Boyacı
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.forename: Engin
authors.initials: E
authors.lastname: Hatem
authors.forename: Murat
authors.initials: M
authors.lastname: Bilgin
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Çelik
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D002637:Chest Pain; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology*; D010343:Patient Admission; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein