Yonsei Med J.  2014 Jan;55(1):132-140. 10.3349/ymj.2014.55.1.132.

Concomitant Impact of High-Sensitivity C-Reactive Protein and Renal Dysfunction in Patients with Acute Myocardial Infarction

• Kang YU
• Kim MJ
• Choi JS
• Kim CS
• Bae EH
• Ma SK
• Ahn YK
• Jeong MH
• Kim YJ
• Cho MC
• Kim CJ
• Kim SW
• Other Korea Acute Myocardial Infarction Registry Investigators

• KMID: 1779897
• DOI: http://doi.org/10.3349/ymj.2014.55.1.132

Abstract

PURPOSE
The present study aimed to investigate the impact of high-sensitivity C-reactive protein (hs-CRP) and renal dysfunction on clinical outcomes in acute myocardial infarction (AMI) patients.
MATERIALS AND METHODS
The study involved a retrospective cohort of 8332 patients admitted with AMI. The participants were divided into 4 groups according to the levels of estimated glomerular filtration rate (eGFR) and hs-CRP: group I, no renal dysfunction (eGFR > or =60 mL.min(-1).1.73 m(-2)) with low hs-CRP (< or =2.0 mg/dL); group II, no renal dysfunction with high hs-CRP; group III, renal dysfunction with low hs-CRP; and group IV, renal dysfunction with high hs-CRP. We compared major adverse cardiac events (MACE) over a 1-year follow-up period.
RESULTS
The 4 groups demonstrated a graded association with increased MACE rates (group I, 8.8%; group II, 13.8%; group III, 18.6%; group IV, 30.1%; p<0.001). In a Cox proportional hazards model, mortality at 12 months increased in groups II, III, and IV compared with group I [hazard ratio (HR) 2.038, 95% confidence interval (CI) 1.450-2.863, p<0.001; HR 3.003, 95% CI 2.269-3.974, p<0.001; HR 5.087, 95% CI 3.755-6.891, p<0.001].
CONCLUSION
High hs-CRP, especially in association with renal dysfunction, is related to the occurrence of composite MACE, and indicates poor prognosis in AMI patients.

Keyword

C-reactive protein; glomerular filtration rate; myocardial infarction

MeSH Terms

Aged
C-Reactive Protein/*metabolism
Coronary Angiography
Female
Humans
Kidney/*physiopathology
Male
Middle Aged
Myocardial Infarction/*metabolism/*radiography
Retrospective Studies
C-Reactive Protein

Figure

• 

  Fig. 1 Cox regression survival curve in patients with acute myocardial infarction over a 1-year follow-up according to each group.

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