Abstract:
Objective To assess the usefulness of in-hospital measurement
of C-reactive protein (CRP) concentration in
comparison to well-established risk factors as a marker of
post-infarct left ventricular systolic dysfunction (LVSD) at
discharge.
Materials and methods Two hundred and four consecutive
patients with ST-segment-elevation myocardial
infarction (STEMI) were prospectively enrolled into the
study. CRP plasma concentrations were measured before
reperfusion, 24 h after admission and at discharge with an
ultra-sensitive latex immunoassay.
Results CRP concentration increased significantly during
the first 24 h of hospitalization (2.4 ± 1.9 vs. 15.7 ± 17.0
mg/L; p\0.001) and persisted elevated at discharge
(14.7 ± 14.7 mg/L), mainly in 57 patients with LVSD
(2.4 ± 1.8 vs. 25.0 ± 23.4 mg/L; p\0.001; CRP at discharge
21.9 ± 18.6 mg/L). The prevalence of LVSD was
significantly increased across increasing tertiles of CRP
concentration both at 24 h after admission (13.2 vs. 19.1
vs. 51.5 %; p\0.0001) and at discharge (14.7 vs. 23.5 vs.
45.6 %; p\0.0001). Multivariate analysis demonstrated
CRP concentration at discharge to be an independent
marker of early LVSD (odds ratio of 1.38 for a 10 mg/L
increase, 95 % confidence interval 1.01–1.87; p\0.04).
Conclusion Measurement of CRP plasma concentration
at discharge may be useful as a marker of early LVSD in
patients after a first STEMI.
