Key result
Elevated C-reactive protein levels immediately after the onset of acute myocardial infarction were independently associated with better preserved regional wall motion (OR 5.93) and less myocardial damage.
Why the study?
The relationship between myocardial damage and C-reactive protein levels immediately after onset of acute myocardial infarction without creatine kinase elevation was unclear.
Is elevated CRP immediately after the onset of acute myocardial infarction associated with less myocardial damage and better left ventricular function?
Observational (n=85)
No
Is elevated CRP immediately after the onset of acute myocardial infarction associated with less myocardial damage and better left ventricular function?
Odds Ratio: 5.93 (95% CI 1.51–23.2)
p-value: p=0.011
Elevated CRP immediately after the onset of reperfused anterior AMI is paradoxically associated with less myocardial damage and better left ventricular function, likely related to a higher incidence of preinfarction angina.
Elevated post-AMI CRP was associated with less damage; hypothesis-generating for preconditioning and should not yet change practice.
The present study investigated the relationship between myocardial damage and C-reactive protein (CRP) levels, with no increase in creatine kinase (CK) activity, immediately after the onset of acute myocardial infarction (AMI) in 85 patients with their first reperfused anterior AMI without CK elevation on admission and no ischemic events during hospitalization. Patients were classified into those with low levels (<0.3 mg/dl) of CRP (Group L; n=67) and those with high levels (> or =0.3 mg/dl) of CRP (Group H; n=18). Group H had a higher proportion of patients with a history of preinfarction angina (89 vs 55%, p<0.01), especially unstable angina. SigmaST in leads V1-6 on admission ECG was lower in Group H than in Group L (14+/-7 vs 21+/-13 mm, p<0.05). Predischarge left ventriculography showed that the left ventricular global ejection fraction (55+/-11 vs 48+/-10%, p<0.01) and SD/chord at the left anterior descending artery lesion (-1.7+/-0.9 vs -2.3+/-0.9, p<0.01) were better in Group H. Multivariate analysis demonstrated that both CRP on admission (p=0.011) and preinfarction angina (p=0.002) were independently associated with better regional wall motion (SD/chord >-2.0) before discharge. These results suggest that the clinical situation of elevated CRP immediately after onset is associated with less myocardial damage and better left ventricular function in reperfused anterior AMI.
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KIMURA et al. (2001) conducted an observational in Acute myocardial infarction (n=85). Elevated C-reactive protein (CRP ≥0.3 mg/dl) vs. Low C-reactive protein (CRP <0.3 mg/dl) was evaluated on Preserved regional wall motion (SD/chord >-2.0) at 14 days (OR 5.93, 95% CI 1.51-23.20, p=0.011). Elevated C-reactive protein levels immediately after the onset of acute myocardial infarction were independently associated with better preserved regional wall motion (OR 5.93) and less myocardial damage.
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