Korean J Intern Med.  2003 Mar;18(1):29-34.

The Role of C-Reactive Protein on the Long-Term Clinical Outcome after Primary or Rescue Percutaneous Coronary Intervention

• Hong YJ
• Jeong MH
• Park OY
• Kim W
• Kim JH
• Ahn YK
• Cho JG
• Ahn BH
• Suh SP
• Park JC
• Kim SH
• Kang JC

Abstract

BACKGROUND
We examined the clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI) and long-term survival rate after primary or rescue PCI in patients with acute myocardial infarction (AMI) according to the level of the C-Reactive Protein (CRP) on admission. METHODS: Two hundred and eight consecutive 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 a 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 an elevated CRP (> or==1.0 mg/dL, mean value=3.50+/-0.93 mg/dL) on admission. RESULTS: There were no significant differences in the baseline characteristics noted between the 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 did not differ between the two groups. The ejection fraction and Thrombolysis In Myocardial Infarction flow grade improved after PCI in both groups. The 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 for Group I were 97.7%, 97.7% and 96.5%, and those for Group II were 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: A high incidence of cardiogenic shock and worse long-term survival after PCI are observed in AMI patients with an elevated CRP.

Keyword

Myocardial infarction; Angioplasty; Shock; Prognosis

MeSH Terms

Age Factors
Aged
Angioplasty, Transluminal, Percutaneous Coronary/*methods/mortality
Biological Markers/analysis
C-Reactive Protein/analysis/*metabolism
Chi-Square Distribution
Cohort Studies
Coronary Angiography
Female
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction/*mortality/radiography/*therapy
Probability
Prognosis
Prospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Survival Analysis
Time Factors
Treatment Outcome