Korean J Med.  2001 Dec;61(6):606-615.

The role of C-reactive protein on long-term clinical outcomes in patients with acute myocardial infarction

• Hong YJ
• Jeong MH
• Park HW
• Lee SH
• Park OY
• Jeong WK
• Lee SR
• Yum JH
• Kim W
• Kim JH
• Rhew JY
• Ahn YK
• Cho JG
• Suh SP
• Ahn BH
• Park JC
• Kim SH
• Kang JC

Abstract

BACKGROUND
The inflammation is an important feature of atherosclerotic lesions, and high level of C-reactive protein (CRP) is known to be associated with increased coronary events and poor prognosis in acute myocardial infarction (AMI). We examined the clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI), and long-term survival rate after PCI according to the level of CRP on admission.
METHODS
Two hundred and eight patients with AMI who underwent primary or rescue PCI between 1997 and 1999 at Chonnam National University Hospital were divided into two groups: Group I (n=86, 59.9+/-9.3 years, male 74.4%) with normal CRP (<1.0 mg/dL, mean value=0.43+/-0.14 mg/dL) on admission and Group II (n=122, 59.1+/-10.4 years, male 83.6%) with elevated CRP (> or = 1.0 mg/dL, mean value=3.50+/-0.93 mg/dL) on admission.
RESULTS
There were no significant differences in baseline characteristics between two groups. The incidence of cardiogenic shock was higher in Group II than in Group I (Group I; 3/86, 3.5% vs Group II; 15/122, 12.3%, p=0.026). The coronary angiographic findings were not different between two groups. The ejection fraction and Thrombolysis In Myocardial Infarction flow were improved after PCI in both groups (Group I; 49.4+/-10.5 to 52.0+/-9.0%, 1.52+/-1.13 to 2.77+/-0.55, p<0.001 vs Group II; 50.1+/-11.2 to 52.7+/-9.7, 1.55+/-1.11 to 2.76+/-0.53, p<0.001). Primary success rate of PCI was 94.2% (81/86) in Group I and 95.1% (116/122) in Group II (p=0.776). The survival rates of Group I was 97.7%, 97.7% and 96.5%, and those of Group II was 91.8%, 91.0% and 86.9% at 1, 6 and 12 months, respectively (p=0.043 at 1 month, p=0.040 at 6 months, p=0.018 at 12 months).
CONCLUSION
Higher incidence of cardiogenic shock and worse long-term survival after PCI are observed in AMI patients with elevated CRP.

Keyword

Acute Myocardial Infarction; Percutaneous Coronary Intervention; C-reactive Protein

MeSH Terms

C-Reactive Protein*
Humans
Incidence
Inflammation
Jeollanam-do
Male
Myocardial Infarction*
Percutaneous Coronary Intervention
Prognosis
Shock, Cardiogenic
Survival Rate
C-Reactive Protein