High-sensitivity C-reactive protein and long term reperfusion success of primary percutaneous intervention in ST-elevation myocardial infarction

Autor: Hilde E. Groot, Jacco C. Karper, Pim van der Harst, Erik Lipsic, Iwan C. C. van der Horst, Dirk J. van Veldhuisen
Přispěvatelé: Cardiovascular Centre (CVC), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
Rok vydání: 2017
Předmět:
Male
medicine.medical_treatment
INFLAMMATORY MARKERS
030204 cardiovascular system & hematology
0302 clinical medicine
High sensitivity C-reactive protein
030212 general & internal medicine
biology
ASSOCIATION
Middle Aged
ADMISSION
Reperfusion injury
C-Reactive Protein
Treatment Outcome
ST-elevation myocardial infarction
medicine.anatomical_structure
Cardiology
Female
TRIAL
Cardiology and Cardiovascular Medicine
TIMI
medicine.medical_specialty
METFORMIN
Myocardial Reperfusion
MECHANISMS
BLUSH GRADE
03 medical and health sciences
Coronary circulation
Percutaneous Coronary Intervention
Coronary Circulation
Internal medicine
Heart rate
medicine
Humans
CORONARY-HEART-DISEASE
cardiovascular diseases
Aged
business.industry
Microcirculation
MORTALITY
C-reactive protein
Percutaneous coronary intervention
medicine.disease
Troponin
hs-CRP
Conventional PCI
biology.protein
ST Elevation Myocardial Infarction
ANGIOGRAPHIC ASSESSMENT
business
Biomarkers
Follow-Up Studies
Zdroj: International Journal of Cardiology, 248, 51-56. ELSEVIER IRELAND LTD
ISSN: 0167-5273
Popis: Aims: In STEMI patients, success of reperfusion of primary PCI predicts cardiac remodeling and clinical outcome. This success may depend on inflammation. We aimed to investigate the association between inflammation and reperfusion success, left ventricular function and long-term mortality in STEMI patients.Methods: In 376 consecutive STEMI patients of the GIPS-III trial hs-CRP levels were measured at baseline, 2 weeks, 7 weeks and 4 months post-PCI. Myocardial blush grade was used to determine success of myocardial reperfusion. In multivariate models sex, age, hs-CRP levels at baseline, NT-proBNP levels at baseline, ischemia time, heart rate, TIMI flow, and CK, CKMB and troponin AUC were included. Follow-up was complete until 4 months.Results: Baseline hs-CRP levels were 2.1 mg/l (IQR 0.5-4.2 mg/l). hs-CRP levels were associated with impaired reperfusion (OR 1.239, 95% CI 1.006-1.527) and remained higher compared to patients with normal reperfusion up to 2 months after PCI (hs-CRP 1.9 mg/l (IQR 0.9-3.7 mg/l) versus 1.5 mg/l (IQR 0.7-2.7 mg/l), p=0.041). In multivariate analysis baseline hs-CRP levels remained independently associated with impaired reperfusion. In patients with impaired reperfusion, hs-CRP and NT-proBNP levels remained higher during 4 months of follow-up. No correlation was observed between hs-CRP at baseline and left ventricular function at 4 months. The number of events was small and we observed no differences in mortality.Conclusion: Increased hs-CRP levels at presentation are associatedwith impaired microvascular reperfusion after PCI in STEMI patients and remain higher until 2 months follow-up. (C) 2017 Published by Elsevier Ireland Ltd.
Databáze: OpenAIRE
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