C-Reactive Protein as a Risk Marker for Post-Infarct Heart Failure over a Multi-Year Period
| Autor: | Jacek Kubica, Przemysław Magielski, Iwona Świątkiewicz |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Time Factors
medicine.medical_treatment Myocardial Infarction heart failure Kaplan-Meier Estimate 030204 cardiovascular system & hematology Systemic inflammation lcsh:Chemistry 0302 clinical medicine Cause of Death Clinical endpoint echocardiography 030212 general & internal medicine Myocardial infarction lcsh:QH301-705.5 Spectroscopy remodeling biology Ventricular Remodeling General Medicine Prognosis Computer Science Applications Hospitalization Quartile Cardiology medicine.symptom medicine.medical_specialty acute myocardial infarction Catalysis Article C-reactive protein Inorganic Chemistry 03 medical and health sciences Internal medicine medicine Humans Physical and Theoretical Chemistry Molecular Biology business.industry Organic Chemistry Percutaneous coronary intervention biomarkers Guideline medicine.disease ischemic heart disease lcsh:Biology (General) lcsh:QD1-999 inflammation Heart failure biology.protein business |
| Zdroj: | International Journal of Molecular Sciences Volume 22 Issue 6 International Journal of Molecular Sciences, Vol 22, Iss 3169, p 3169 (2021) |
| ISSN: | 1422-0067 |
| DOI: | 10.3390/ijms22063169 |
| Popis: | Inflammatory activation during acute ST-elevation myocardial infarction (STEMI) can contribute to post-infarct heart failure (HF). This study aimed to determine prognostic value of high-sensitivity C-reactive protein concentration (CRP) for HF over a long-term follow-up in 204 patients with a first STEMI undergoing guideline-based therapies including percutaneous coronary intervention. CRP was measured at admission, 24 h (CRP24), discharge (CRPDC), and one month (CRP1M) after index hospitalization for STEMI. Within a median period of 5.6 years post-index hospitalization for STEMI, hospitalization for HF (HFH) which is a primary endpoint, occurred in 24 patients (11.8%, HF+ group). During the study, 8.3% of HF+ patients died vs. 1.7% of patients without HFH (HF- group) (p = 0.047). CRP24, CRPDC, and CRP1M were significantly higher in HF+ compared to HF- group. The median CRP1M in HF+ group was 2.57 mg/L indicating low-grade systemic inflammation, in contrast to 1.54 mg/L in HF- group. CRP1M ≥ 2 mg/L occurred in 58.3% of HF+ vs. 42.8% of HF- group (p = 0.01). Kaplan–Meier analysis showed decreased probability of survival free from HFH in patients with CRP24 (p < 0.001), CRPDC (p < 0.001), and CRP1M (p = 0.03) in quartile IV compared to lower quartiles. In multivariable analysis, CRPDC significantly improved prediction of HFH over a multi-year period post-STEMI. Persistent elevation in CRP post STEMI aids in risk stratification for long-term HF and suggests that ongoing cardiac and low-grade systemic inflammation promote HF development despite guideline-based therapies. |
| Databáze: | OpenAIRE |
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