Objective To explore the relationship between high-sensitivity C-reactive protein and the prognosis of patients with acute myocardial infarction after percutaneous coronary intervention.
Methods The study comprised 100 consecutive patients with first attack of acute myocardial infarction. They underwent primary PCI within 12 h after the onset of chest pain. According to their serum hs-CRP level, these patients were divided into three groups: A Group (hs-CRP<3mg/L, n=18), B Group (3 mg/l ≤hs-CRP<10 mg/l, n=32) and C Group (hs-CRP>10 mg/l, n=50). The incidence of MACE within 180 postoperative days was followed.
Results There were no significant differences in age, sex, smoke, hyperlipidaemia, diabetes mellitus, Cardiac troponin I and Low-density lipoprotein cholesterol among the three groups (p>0.05). There were significant differences in the serum hs-CRP levels. Left ventricular ejection fraction, hypertension, left anterior descending coronary atery and anterior wall (p<0.05). Follow-up for 180 days showed that there were significant differences in the incidence of heart failure within 30 days or 180 days and revascularisation rate within 180 days among the three groups (p<0.05). Using Binary logistic regression analysis, by step-back (LR) method, indicated that high concentration of hs-CRP remained an independent predicator of MACE during hospitalisation and within 30 days (OR=2.42, 95% CI=1.020 to 5.746, p=0.045); (OR=2.187, 95% CI 1.028 to 4.653, p=0.042). It is a more useful predictor for the incidence of heart failure within 30 days (OR=2.565, 95% CI=1.032 to 6.375, p=0.043).
Conclusion High level hs-CRP measured after the primary PCI is the independent predictive factors of MACE for the patients with first attack of AMI during hospitalisation and within 30 days. It has a stronger predictive value, especially for the incidence of heart failure within 30 days. The patients of high level hs-CRP group is more than the normal hs-CRP group in the occurrence of MACE during hospitalisation and within 30 days and the occurrence of heart failure within 30 days.
- Acute myocardial infarction
- hypersensitive C-reactive protein
- percutaneous coronary intervention
- major adverse cardiac events