Key result
High preprocedural C-reactive protein levels were associated with a significantly increased risk of in-hospital all-cause mortality (RR 5.62) in patients with STEMI undergoing primary percutaneous coronary intervention.
Why the study?
Does high pre-procedural C-reactive protein predict adverse clinical outcomes in patients with STEMI undergoing primary percutaneous coronary intervention?
Meta-Analysis (n=6,993)
Does high pre-procedural C-reactive protein predict adverse clinical outcomes in patients with STEMI undergoing primary percutaneous coronary intervention?
Answers are grounded in this paper and cite their sources.
Pre-procedural serum CRP is a valuable predictor of global cardiovascular risk, including mortality and MACE, in STEMI patients undergoing primary PCI.
Risk assessment in patients with acute coronary syndromes (ACS) is critical in order to provide adequate treatment. We performed a systematic meta-analysis to assess the predictive role of serum C-reactive protein (CRP) in patients with ST-segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention (PPCI). We included 7 studies, out of 1,033 studies, with a total of 6,993 patients with STEMI undergoing PPCI, which were divided in the high or low CRP group, according to the validated cut-off values provided by the corresponding CRP assay. High CRP values were associated with increased in-hospital and follow-up all-cause mortality, in-hospital and follow-up major adverse cardiac events (MACE), and recurrent myocardial infarction (MI). The pre-procedural CRP predicted in-hospital target vessel revascularization (TVR), but was not associated with acute/subacute and follow-up in-stent restenosis (ISR), and follow-up TVR. Thus, pre-procedural serum CRP could be a valuable predictor of global cardiovascular risk, rather than a predictor of stent-related complications in patients with STEMI undergoing PPCI. This biomarker might have the potential to improve the management of these high-risk patients.
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Mincu et al. (2017) conducted a meta-analysis in ST-segment elevation myocardial infarction (STEMI) (n=6,993). High preprocedural C-reactive protein (CRP) vs. Low preprocedural C-reactive protein (CRP) was evaluated on In-hospital all-cause mortality (RR 5.62, 95% CI 3.59-8.78, p=<0.001). High preprocedural C-reactive protein levels were associated with a significantly increased risk of in-hospital all-cause mortality (RR 5.62) in patients with STEMI undergoing primary percutaneous coronary intervention.
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