Usefulness of C-reactive protein and left ventricular function for risk assessment in survivors of acute myocardial infarction

• Published in: The American journal of cardiology 2004-09, Vol.94 (6), p.766-769
• Main Authors: Sanchis, Juan, Bodí, Vicent, Llácer, Àngel, Núñez, Julio, Facila, Lorenzo, Ruiz, Vicente, Blasco, Marisa, Sanjuán, Rafael, Chorro, Francisco J.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers - blood; C-Reactive Protein - metabolism; Cardiology. Vascular system; Chi-Square Distribution; Coronary heart disease; Female; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Multivariate Analysis; Myocardial Infarction - metabolism; Myocardial Infarction - pathology; Myocarditis. Cardiomyopathies; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Assessment; Ventricular Dysfunction, Left - metabolism; Ventricular Dysfunction, Left - pathology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2004.05.062

The additional prognostic information provided by C-reactive protein (CRP) to parameters of left ventricular function in survivors of acute myocardial infarction (AMI) was investigated in 665 patients (326 with ST elevation and 339 with non-ST elevation). Cox multivariable analysis identified the following predictors of 6-month cardiac death: age (per 5 years hazard ratio [HR] 1.2, 95% confidence interval [CI] 1.1 to 1.4, p = 0.004), Killip class >I at presentation (HR 2.4, 95% CI 1.3 to 4.5, p = 0.0001), a reduced ejection fraction (per 5% HR 1.3, 95% CI 1.2 to 1.4, p = 0.0001), and greater CRP (per 5 mg/L HR 1.02, 95% CI 1.01 to 1.04, p = 0.02); the C-index of the model was 0.77 without and 0.78 with CRP. CRP is associated with mortality in addition to age and parameters of ventricular function (Killip class and ejection fraction) in survivors of AMI, although the relevance of its additive predictive role seems marginal.