Serum C-reactive protein concentration in acute myocardial infarction and its relationship to mortality during 24 months of follow-up in patients under thrombolytic treatment

• Published in: European heart journal 1996-09, Vol.17 (9), p.1345-1349
• Main Authors: Pietllä, K. O., Harmoinen, A. P., Jokiniitty, J., Pasternack, A. I.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; C-reactive protein; C-Reactive Protein - analysis; C-Reactive Protein - metabolism; Confidence Intervals; congestive heart failure; Death, Sudden, Cardiac - etiology; Female; Follow-Up Studies; Heart Failure - etiology; Heart Failure - mortality; Humans; Male; Medical sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Myocardial Infarction - pathology; Pharmacology. Drug treatments; Prognosis; Sensitivity and Specificity; sudden cardiac death; survival; Survival Rate; Thrombolytic Therapy; Time Factors
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/oxfordjournals.eurheartj.a015068

Objectives We studied the relationship between serum C-reactive protein and mortality in acute myocardial infarction. Background Early recanalization of an infarct-related coronary artery is considered to be an essential prerequisite for reducing mortality by thrombolytic treatment in acute myocardial infarction. It also reduces the inflammatory reaction caused by acute myocardial infarction and is measurable by determination of serum C-reactive protein concentrations. We therefore studied the prognostic value of determining serum C-reactive protein in acute myocardial infarction. Methods We measured serum C-reactive protein concentrations daily for 6 days and creatine kinase, as well as its MB isoenzyme concentrations twice a day, for 3 days after a myocardial infarct, in 188 consecutive patients selected for thrombolytic therapy and treated in the same University Hospital Coronary Care Unit. The highest serum concentrations were related to total mortality as well as to the causes of death 3, 3–6, 6–12 and 12–24 months after the onset of the myocardial infarction. Results The highest serum concentrations of serum C-reactive protein were observed 2 to 4 days after the onset of myocardial infarction. The mean value of the highest serum concentration of C-reactive protein in patients who survived the whole 24-month study period was 65 mg. l−1 with the 95% confidence intervals for the mean ranging from 58 to 71. The corresponding values in those who died within 3, 3–6, 6–12 and 12–24 months were 166 (139–194), 136 (88–184), 85 (52–119) and 74 (38–111) mg.l−1 respectively. The values in those who died within 3 and 3–6 months of the infarction differed statistically significantly from the values in those who survived the whole period (P