title: High-sensitivity C-reactive protein as a predictor of cardiovascular events after ST-elevation myocardial infarction.
abstract: BACKGROUND
  The association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.
  
  
  OBJECTIVE
  To investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.
  
  
  METHODS
  This prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.
  
  
  RESULTS
  The mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.
  
  
  CONCLUSIONS
  Although high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Daniel Rios Pinto
authors.initials: DR
authors.lastname: Ribeiro
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Adriane Monserrat
authors.initials: AM
authors.lastname: Ramos
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Pedro Lima
authors.initials: PL
authors.lastname: Vieira
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Menti
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Odemir Luiz
authors.initials: OL
authors.lastname: Bordin
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Priscilla Azambuja Lopes de
authors.initials: PA
authors.lastname: Souza
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Alexandre Schaan de
authors.initials: AS
authors.lastname: Quadros
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Vera Lúcia
authors.initials: VL
authors.lastname: Portal
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein