Assi Milwidsky1, Tomer Ziv-Baran2, Sevan Letourneau-Shesaf1, Gad Keren1, Philippe Taieb3, Shlomo Berliner3, Yacov Shacham1. 1. a Department of Cardiology , Tel-Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel. 2. b Department of Epidemiology and Preventative Medicine , School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel. 3. c Department of Internal Medicine "E" , Tel-Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel.
Abstract
CONTEXT: There is a known association between C-reactive protein (CRP) levels and adverse outcomes in patients presenting with ST-elevation myocardial infarction (STEMI). The optimal time frame to measure CRP for risk stratification is not known. OBJECTIVE: The aim of the current study was to evaluate the relation between the change in CRP velocity (CRPv) and 30-d mortality among STEMI patients. MATERIAL AND METHODS: We included consecutive patients with a diagnosis of STEMI who presented to Tel-Aviv Medical Center between 2008 and 2014 and had their CRP measured with a wide range assay (wr-CRP) at least twice during the 24 h after admission. CRPv was defined as the change in wr-CRP concentration (mg/l) divided by the change in time (in hours) between the two measurements. RESULTS: The study population comprised of 492 patients, mean age was 62 ± 14, 80% were male. CRPv was significantly higher among patients who died within 30 d of admission (1.42 mg/l versus 0.18 mg/l, p < 0.001). In a multivariate regression model adjusted to multiple confounders, CRPv was independently associated with 30-d mortality (OR 1.39, 95% CI: 1.20-1.62, p < 0.001). CONCLUSION: CRPv might be an independent and rapidly measurable biomarker for short-term mortality in patients presenting with STEMI.
CONTEXT: There is a known association between C-reactive protein (CRP) levels and adverse outcomes in patients presenting with ST-elevation myocardial infarction (STEMI). The optimal time frame to measure CRP for risk stratification is not known. OBJECTIVE: The aim of the current study was to evaluate the relation between the change in CRP velocity (CRPv) and 30-d mortality among STEMI patients. MATERIAL AND METHODS: We included consecutive patients with a diagnosis of STEMI who presented to Tel-Aviv Medical Center between 2008 and 2014 and had their CRP measured with a wide range assay (wr-CRP) at least twice during the 24 h after admission. CRPv was defined as the change in wr-CRP concentration (mg/l) divided by the change in time (in hours) between the two measurements. RESULTS: The study population comprised of 492 patients, mean age was 62 ± 14, 80% were male. CRPv was significantly higher among patients who died within 30 d of admission (1.42 mg/l versus 0.18 mg/l, p < 0.001). In a multivariate regression model adjusted to multiple confounders, CRPv was independently associated with 30-d mortality (OR 1.39, 95% CI: 1.20-1.62, p < 0.001). CONCLUSION:CRPv might be an independent and rapidly measurable biomarker for short-term mortality in patients presenting with STEMI.
Authors: Magdalena Holzknecht; Christina Tiller; Martin Reindl; Ivan Lechner; Priscilla Fink; Patrick Lunger; Agnes Mayr; Benjamin Henninger; Christoph Brenner; Gert Klug; Axel Bauer; Bernhard Metzler; Sebastian Johannes Reinstadler Journal: J Clin Med Date: 2021-11-24 Impact factor: 4.241