Early inflammation and risk of long-term development of heart failure and mortality in survivors of acute myocardial infarction: Predictive role of C-reactive protein

Mahmoud Suleiman, Rania Khatib, Yoram Agmon, Riad Mahamid, Monther Boulos, Michael Kapeliovich, Yishai Levy, Rafael Beyar, Walter Markiewicz, Haim Hammerman, Doron Aronson

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: We aimed to study the relationship between C-reactive-protein (CRP), obtained within 12 to 24 h of symptoms onset, and long-term risk of death and heart failure (HF) in survivors of acute myocardial infarction (MI). BACKGROUND: A robust inflammatory response is an integral component of the response to tissue injury during MI. The magnitude of the early inflammatory response to ischemic injury might be an important determinant of long-term outcome. METHODS: We prospectively studied 1,044 patients admitted with acute MI and discharged from hospital in stable condition. RESULTS: During a median follow-up of 23 months (range, 6 to 42 months), 113 patients died and 112 developed HF. In a multivariable Cox regression model adjusting for clinical variables and predischarge ejection fraction, compared with patients in the first CRP quartile, the adjusted hazard ratios (HRs) for death progressively increased with higher quartiles of CRP (second quartile 1.4 [95% confidence interval (CI) 0.6 to 2.9]; third quartile 2.3 [95% CI 1.2 to 4.6]; fourth quartile 3.0 [95% CI 1.5 to 5.7]; for trend, p = 0.0002). Compared with patients in the first CRP quartile, the adjusted HRs for HF were: second quartile, 1.1 (95% CI 0.5 to 2.3); third quartile, 1.9 (95% CI 1.0 to 3.6); and fourth quartile, 2.1 (95% CI 1.2 to 3.9) (for trend, p = 0.005). CONCLUSIONS: C-reactive-protein is a marker of long-term development of HF and mortality in patients with acute MI and provides prognostic information beyond that provided by conventional risk factors and the degree of left ventricular systolic dysfunction.

Original languageEnglish (US)
Pages (from-to)962-968
Number of pages7
JournalJournal of the American College of Cardiology
Volume47
Issue number5
DOIs
StatePublished - Mar 7 2006
Externally publishedYes

ASJC Scopus subject areas

  • Nursing(all)

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