Hilde E Groot1, Jacco C Karper1, Erik Lipsic1, Dirk J van Veldhuisen1, Iwan C C van der Horst2, Pim van der Harst3. 1. University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands. 2. University of Groningen, University Medical Center Groningen, Department of Critical Care, Groningen, The Netherlands. 3. University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands. Electronic address: p.van.der.harst@umcg.nl.
Abstract
AIMS: In STEMI patients, success of reperfusion of primary PCI predicts cardiac remodeling and clinical outcome. This success may depend on inflammation. We aimed to investigate the association between inflammation and reperfusion success, left ventricular function and long-term mortality in STEMI patients. METHODS: In 376 consecutive STEMI patients of the GIPS-III trial hs-CRP levels were measured at baseline, 2weeks, 7weeks and 4months post-PCI. Myocardial blush grade was used to determine success of myocardial reperfusion. In multivariate models sex, age, hs-CRP levels at baseline, NT-proBNP levels at baseline, ischemia time, heart rate, TIMI flow, and CK, CKMB and troponin AUC were included. Follow-up was complete until 4months. RESULTS: Baseline hs-CRP levels were 2.1mg/l (IQR 0.5-4.2mg/l). hs-CRP levels were associated with impaired reperfusion (OR 1.239, 95% CI 1.006-1.527) and remained higher compared to patients with normal reperfusion up to 2months after PCI (hs-CRP 1.9mg/l (IQR 0.9-3.7mg/l) versus 1.5mg/l (IQR 0.7-2.7mg/l), p=0.041). In multivariate analysis baseline hs-CRP levels remained independently associated with impaired reperfusion. In patients with impaired reperfusion, hs-CRP and NT-proBNP levels remained higher during 4months of follow-up. No correlation was observed between hs-CRP at baseline and left ventricular function at 4months. The number of events was small and we observed no differences in mortality. CONCLUSION: Increased hs-CRP levels at presentation are associated with impaired microvascular reperfusion after PCI in STEMI patients and remain higher until 2months follow-up.
AIMS: In STEMI patients, success of reperfusion of primary PCI predicts cardiac remodeling and clinical outcome. This success may depend on inflammation. We aimed to investigate the association between inflammation and reperfusion success, left ventricular function and long-term mortality in STEMI patients. METHODS: In 376 consecutive STEMI patients of the GIPS-III trial hs-CRP levels were measured at baseline, 2weeks, 7weeks and 4months post-PCI. Myocardial blush grade was used to determine success of myocardial reperfusion. In multivariate models sex, age, hs-CRP levels at baseline, NT-proBNP levels at baseline, ischemia time, heart rate, TIMI flow, and CK, CKMB and troponin AUC were included. Follow-up was complete until 4months. RESULTS: Baseline hs-CRP levels were 2.1mg/l (IQR 0.5-4.2mg/l). hs-CRP levels were associated with impaired reperfusion (OR 1.239, 95% CI 1.006-1.527) and remained higher compared to patients with normal reperfusion up to 2months after PCI (hs-CRP 1.9mg/l (IQR 0.9-3.7mg/l) versus 1.5mg/l (IQR 0.7-2.7mg/l), p=0.041). In multivariate analysis baseline hs-CRP levels remained independently associated with impaired reperfusion. In patients with impaired reperfusion, hs-CRP and NT-proBNP levels remained higher during 4months of follow-up. No correlation was observed between hs-CRP at baseline and left ventricular function at 4months. The number of events was small and we observed no differences in mortality. CONCLUSION: Increased hs-CRP levels at presentation are associated with impaired microvascular reperfusion after PCI in STEMI patients and remain higher until 2months follow-up.
Authors: Iwona Świątkiewicz; Przemysław Magielski; Jacek Kubica; Adena Zadourian; Anthony N DeMaria; Pam R Taub Journal: Int J Mol Sci Date: 2020-01-26 Impact factor: 5.923
Authors: Mohammad A Almesned; Femke M Prins; Erik Lipšic; Margery A Connelly; Erwin Garcia; Robin P F Dullaart; Hilde E Groot; Pim van der Harst Journal: J Clin Med Date: 2021-12-01 Impact factor: 4.241
Authors: Hilde E Groot; Lawien Al Ali; Iwan C C van der Horst; Remco A J Schurer; Hindrik W van der Werf; Erik Lipsic; Dirk J van Veldhuisen; Jacco C Karper; Pim van der Harst Journal: Clin Res Cardiol Date: 2018-10-26 Impact factor: 5.460