BACKGROUND: In patients with acute ST-elevation myocardial infarction (STEMI), elevated concentrations of inflammatory markers are correlated with worse clinical outcome. The aim of this study was comprehensively to investigate the relationship of circulating markers of inflammation with myocardial and microvascular damage after STEMI. METHODS: In 111 consecutive STEMI patients, blood samples were obtained on admission and from day 1 to day 4 after primary percutaneous coronary intervention and analysed for high-sensitivity C-reactive protein (hs-CRP), white blood cell count and fibrinogen. Cardiac magnetic resonance imaging was performed within the first week and 4 months after primary percutaneous coronary intervention. RESULTS: Peak concentrations of hs-CRP (20.5 (9.6-44.4) mg/L), white blood cell count (12.4 (10.5-15.3) G/L) and fibrinogen (3640 (3150-4550) mg/L) showed significant correlations with both infarct size ( r=0.31 to 0.41; P<0.01) and left ventricular ejection fraction ( r=-0.29 to -0.39; P<0.01) assessed in the acute as well as chronic stage following STEMI. Furthermore, peak concentrations of these inflammatory markers were significantly higher in patients with microvascular obstruction compared to patients without microvascular obstruction ( P⩽0.01). C-statistics revealed that the prognostic values of all three biomarkers for the prediction of large chronic infarct size (>8% of left ventricular myocardial mass) were moderate without significant differences (area under the curve: hs-CRP 0.73 (95% confidence interval (CI) 0.63-0.82), white blood cell count 0.67 (95% CI 0.56-0.78) and fibrinogen 0.69 (95% CI 0.59-0.79); all P>0.12). Combination of inflammatory markers did not significantly increase the area under the curve ( P>0.05). CONCLUSION: In reperfused STEMI patients, increased levels of hs-CRP, white blood cell count and fibrinogen are associated with decreased left ventricular function and more pronounced myocardial damage at baseline and 4 months after infarction.
BACKGROUND: In patients with acute ST-elevation myocardial infarction (STEMI), elevated concentrations of inflammatory markers are correlated with worse clinical outcome. The aim of this study was comprehensively to investigate the relationship of circulating markers of inflammation with myocardial and microvascular damage after STEMI. METHODS: In 111 consecutive STEMI patients, blood samples were obtained on admission and from day 1 to day 4 after primary percutaneous coronary intervention and analysed for high-sensitivity C-reactive protein (hs-CRP), white blood cell count and fibrinogen. Cardiac magnetic resonance imaging was performed within the first week and 4 months after primary percutaneous coronary intervention. RESULTS: Peak concentrations of hs-CRP (20.5 (9.6-44.4) mg/L), white blood cell count (12.4 (10.5-15.3) G/L) and fibrinogen (3640 (3150-4550) mg/L) showed significant correlations with both infarct size ( r=0.31 to 0.41; P<0.01) and left ventricular ejection fraction ( r=-0.29 to -0.39; P<0.01) assessed in the acute as well as chronic stage following STEMI. Furthermore, peak concentrations of these inflammatory markers were significantly higher in patients with microvascular obstruction compared to patients without microvascular obstruction ( P⩽0.01). C-statistics revealed that the prognostic values of all three biomarkers for the prediction of large chronic infarct size (>8% of left ventricular myocardial mass) were moderate without significant differences (area under the curve: hs-CRP 0.73 (95% confidence interval (CI) 0.63-0.82), white blood cell count 0.67 (95% CI 0.56-0.78) and fibrinogen 0.69 (95% CI 0.59-0.79); all P>0.12). Combination of inflammatory markers did not significantly increase the area under the curve ( P>0.05). CONCLUSION: In reperfused STEMI patients, increased levels of hs-CRP, white blood cell count and fibrinogen are associated with decreased left ventricular function and more pronounced myocardial damage at baseline and 4 months after infarction.
Entities:
Keywords:
ST-elevation myocardial infarction; fibrinogen; high-sensitivity C-reactive protein; inflammatory markers; magnetic resonance imaging; white blood cell count
Authors: C B Holt; J A Østergaard; S Thiel; T K Hansen; L Mellbin; P Sörensson; M Bjerre Journal: Clin Exp Immunol Date: 2019-06-03 Impact factor: 4.330
Authors: Maarten Vanhaverbeke; Denise Veltman; Stefan Janssens; Peter R Sinnaeve Journal: J Cardiovasc Transl Res Date: 2020-06-30 Impact factor: 4.132
Authors: Sebastian Johannes Reinstadler; Hans-Josef Feistritzer; Martin Reindl; Gert Klug; Agnes Mayr; Johannes Mair; Werner Jaschke; Bernhard Metzler Journal: Open Heart Date: 2016-09-20
Authors: Martin Reindl; Sebastian Johannes Reinstadler; Christina Tiller; Hans-Josef Feistritzer; Markus Kofler; Alexandra Brix; Agnes Mayr; Gert Klug; Bernhard Metzler Journal: Eur Radiol Date: 2018-12-13 Impact factor: 5.315
Authors: Martin Reindl; Sebastian Johannes Reinstadler; Hans-Josef Feistritzer; Markus Theurl; Daniel Basic; Christopher Eigler; Magdalena Holzknecht; Johannes Mair; Agnes Mayr; Gert Klug; Bernhard Metzler Journal: J Am Heart Assoc Date: 2017-10-10 Impact factor: 5.501
Authors: Hans-Josef Feistritzer; Gert Klug; Sebastian J Reinstadler; Martin Reindl; Lea Niess; Timo Nalbach; Christian Kremser; Agnes Mayr; Bernhard Metzler Journal: J Am Heart Assoc Date: 2017-09-08 Impact factor: 5.501
Authors: Martin Reindl; Christina Tiller; Magdalena Holzknecht; Ivan Lechner; Benjamin Henninger; Agnes Mayr; Christoph Brenner; Gert Klug; Axel Bauer; Bernhard Metzler; Sebastian J Reinstadler Journal: JAMA Netw Open Date: 2020-06-01