Key result
High levels of hs-CRP in acute anterior STEMI patients were significantly associated with a severe reduction in left ventricular ejection fraction compared to the lowest hs-CRP group (30.4% vs 49.6%, p<0.001).
Why the study?
The study was designed to evaluate the association between hs-CRP and left ventricular systolic dysfunction in acute anterior myocardial infarction for early detection of heart failure.
Is high sensitive C-reactive protein associated with the severity of left ventricular systolic dysfunction in patients with acute anterior STEMI?
Cross-Sectional (n=135)
No
Is high sensitive C-reactive protein associated with the severity of left ventricular systolic dysfunction in patients with acute anterior STEMI?
Absolute Event Rate: 30.4% vs 49.6%
p-value: p=<0.001
Higher hs-CRP levels measured 24-48 hours after acute anterior STEMI are associated with more severe left ventricular systolic dysfunction, suggesting its potential as an early prognostic marker.
hs-CRP may flag more severe LV dysfunction post-anterior STEMI; leaves open prognostic utility and causality in prospective studies.
High Sensitive C-reactive protein (hs- CRP) is an established risk marker in coronary artery disease. It is a marker of inflammation activated early after Acute Myocardial Infarction (AMI) and its quantity depends upon extent of myocardial damage. Release of inflammatory marker occur after acute myocardial infarction leading to cardiac remodeling which clinically manifests as Heart failure (HF). Heart failure is a common complication after acute anterior myocardial infarction (AMI). The prevalence of post-infarct Left Ventricular Systolic Dysfunction (LVSD) ranges from 27 to 60 % and half of patients having early post-infarct LVSD subsequently develop chronic heart failure. The purpose of this study is to show association between hs-CRP with LVSD in AMI and early detection of HF. This was a cross-sectional analytical study in which hs-CRP was done among all the study subjects between 24-48 hours after onset of AMI. The study population was categorized into groups I, II, II according to the lowest to highest hs-CRP level. Transthoracic echocardiography was done between 24-48 hours of anterior ST Elevation Myocardial Infarction (STEMI). Then LVSD was assessed between those three groups and searched for association. Severely reduced ejection fraction (EF) was found in patients of group III (highest hs-CRP tertile) only. Severe and moderately reduced EF and FS was found significantly more in group III and II than group I (mid and lowest hs-CRP tertile) (p<0.001). High level of hs-CRP in patient of acute anterior STEMI patients was associated with moderate to severe reduction in EF and Fractional Shortening (FS). So hs- CRP may be a prognostic marker in acute anterior STEMI complicating LVSD and early management would improved the short and long term prognosis.
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Rahman et al. (2018) conducted a cross-sectional in Acute anterior ST Elevation Myocardial Infarction (STEMI) (n=135). High sensitive C-reactive protein (hs-CRP) vs. Lowest hs-CRP tertile (12-46 mg/L) was evaluated on Left ventricular ejection fraction (EF) (p=<0.001). High levels of hs-CRP in acute anterior STEMI patients were significantly associated with a severe reduction in left ventricular ejection fraction compared to the lowest hs-CRP group (30.4% vs 49.6%, p<0.001).
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