Prognostic Usefulness of Serial C-Reactive Protein Measurements in ST-Elevation Acute Myocardial Infarction

2013 ◽  
Vol 111 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Stamatis S. Makrygiannis ◽  
Olga S. Ampartzidou ◽  
Michael N. Zairis ◽  
Nikolaos G. Patsourakos ◽  
Christos Pitsavos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction

Association of C-reactive protein and myocardial perfusion in patients with ST-elevation acute myocardial infarction

2006 ◽  
Vol 186 (1) ◽  
pp. 177-183 ◽  
Author(s):  
Rainer Hoffmann ◽  
Hasna Suliman ◽  
Philipp Haager ◽  
Philipp Christott ◽  
Wolfgang Lepper ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Myocardial Perfusion ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction

scholarly journals Paraoxonase-1 55 LL Genotype Is Associated with No ST-Elevation Myocardial Infarction and with High Levels of Myoglobin

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Francesca Marchegiani ◽  
Liana Spazzafumo ◽  
Maurizio Cardelli ◽  
Mauro Provinciali ◽  
Francesco Lescai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Paraoxonase 1 ◽  
Ischemic Damage ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Serum Paraoxonase

It is well known that serum paraoxonase (PON1) plays an important role in the protection of LDL from oxidation. PON1 55 polymorphism is currently investigated for its possible involvement in cardiovascular diseases. The objective of our study is to verify if PON1 55 polymorphism is associated with risk of acute coronary syndrome (ACS) and with biochemical myocardial ischemia markers, such as troponin I, creatine kinase (CK)-MB, myoglobin, and C-reactive protein. We analysed PON1 55 polymorphism in a total of 440 elderly patients who underwent an ACS episode: 98 patients affected by unstable angina (UA), 207 AMI (acute myocardial infarction) patients affected by STEMI (ST elevation), and 135 AMI patients affected by NSTEMI (no ST elevation). We found that individuals carrying PON1 55 LL genotype are significantly more represented among AMI patients affected by NSTEMI; moreover, the patients carrying LL genotype showed significantly higher levels of myoglobin in comparison to LM + MM carriers patients. Our study suggests that PON1 55 polymorphism could play a role in the pathogenesis of cardiac ischemic damage. In particular, the significant association between PON1 55 LL genotype and the occurrence of a NSTEMI may contribute to improve the stratification of the cardiovascular risk within a population.

On-admission Serum High-Sensitivity C-Reactive Protein Level Independently Predicts In-Hospital Mortality and Adverse Cardiovascular Events in ST-elevation Acute Myocardial Infarction

2021 ◽  
pp. 263246362110553
Author(s):  
Anggoro Budi Hartopo ◽  
Indah Sukmasari ◽  
Maria Patricia Inggriani ◽  
Thomas Rikl ◽  
Stefi Geovani Valentin Hayon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Events ◽  
Multivariable Analysis ◽  
High Sensitivity ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
St Elevation ◽  
Hs Crp ◽  
Elevation Acute Myocardial Infarction

Background: Inflammatory biomarkers are associated with adverse cardiovascular events during ST-elevation acute myocardial infarction (STEMI). We aimed to investigate the role of inflammatory biomarkers, high-sensitivity C-reactive protein (hs-CRP), and soluble ST-2 (sST2), for prediction of adverse cardiovascular events in STEMI. Methods: This was a prospective cohort study that consecutively enrolled patients with STEMI. Subjects were observed during hospitalization until discharge or fatal events happened. Adverse cardiovascular event was a compilation of cardiac mortality, acute heart failure, cardiogenic shock, reinfarction, and malignant ventricular arrhythmia. Blood samples were withdrawn on admission and inflammatory biomarkers (hs-CRP and sST2) were measured. The receiver operator characteristics curve and multivariable analysis were performed to determine which inflammatory biomarkers predict in-hospital adverse cardiovascular events and mortality. Result: Of 166 subjects, the in-hospital adverse cardiovascular events occurred in 41 subjects (24.6%) and mortality occurred in 16 subjects (9.6%). Subjects with in-hospital adverse cardiovascular events and mortality had a significantly higher hs-CRP level, but comparable sST2 level than subjects without events. The hs-CRP level was the most precise biomarkers to predict in-hospital adverse cardiovascular events (hs-CRP cut-off ≥2.75 mg/L) and mortality (hs-CRP cut-off ≥7 mg/L). Multivariable analysis indicated hs-CRP ≥2.75 mg/L as an independent predictor for in-hospital adverse cardiovascular events (adjusted odds ratio [OR]: 2.79, 95% confidence interval [CI]: 1.05-7.39, P = .039) and hs-CRP ≥7 mg/L for mortality (adjusted OR: 5.45, 95% CI: 1.13-26.18, P = .034) in STEMI. Conclusion: On admission, hs-CRP level independently predicted in-hospital adverse cardiovascular events, at cut-off level ≥2.75 mg/L, and mortality, at cut-off level ≥7 mg/L, in STEMI patients.

C-Reactive protein levels on admission are associated with response to thrombolysis and prognosis after ST-segment elevation acute myocardial infarction

2002 ◽  
Vol 144 (5) ◽  
pp. 782-789 ◽  
Author(s):  
Michael N. Zairis ◽  
Stavros J. Manousakis ◽  
Alexander S. Stefanidis ◽  
Olga A. Papadaki ◽  
George K. Andrikopoulos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Protein Levels ◽  
Reactive Protein ◽  
St Segment ◽  
Elevation Acute Myocardial Infarction

The c- reactive protein to troponin ratio enhances the differentiation of perimyocarditis from acute myocardial infarction

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
O Kobo ◽  
SR Meisel ◽  
N Hamuda ◽  
R Natour ◽  
M Saada ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
C Reactive Protein ◽  
Large Hospital ◽  
Reactive Protein ◽  
Funding Sources ◽  
St Elevation ◽  
Hospital Registry ◽  
Median Admission ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Differentiating perimyocarditis from acute myocardial infarction (AMI) is frequently difficult . Perimyocarditis is primarily an inflammatory disease associated with high C-reactive protein (CRP) and relatively low elevated troponin concentrations, while AMI is characterized by the opposite. We surmised that the CRP/troponin ratio on presentation could improve the differentiation between these two clinical entities.  We evaluated the CRP/troponin ratio on presentation among patients consecutively included in a large hospital registry that included 1898 consecutive patients comprising 1025 ST-elevation myocardial infarction (STEMI) patients, 518 Non-STEMI (NSTEMI) patients, and 355 patients diagnosed as perimyocarditis. CRP and troponin were sampled on admission and their ratio was assessed against discharge diagnosis. ROC analysis of the CRP/troponin ratios evaluated the diagnostic accuracy of perimyocarditis against STEMI with or without NSTEMI. Median admission CRP/troponin ratios were 84, 65, and 436 mg × ml/liter × ng in STEMI, NSTEMI and perimyocarditis groups, respectively (p < 0.001) demonstrating good differentiating capability. The ROC of admission CRP/troponin ratio for diagnosis of perimyocarditis against STEMI with or without NSTEMI yielded a similar AUC of 0.74 and 0.73, respectively. CRP/troponin ratio > 500 resulted in specificity exceeding 85%.  The CRP/troponin ratio is an effective tool that enhances the differentiation between perimyocarditis and AMI.

scholarly journals Differentiation between myopericarditis and acute myocardial infarction on presentation in the emergency department using the admission C-reactive protein to troponin ratio

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248365
Author(s):  
Simcha R. Meisel ◽  
Hamuda Nashed ◽  
Randa Natour ◽  
Rami Abu Fanne ◽  
Majdi Saada ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Roc Analysis ◽  
Area Under The Curve ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
St Elevation ◽  
Operator Curve ◽  
Median Admission

Background The treatment of myopericarditis is different than that of acute myocardial infarction (AMI). However, since their clinical presentation is frequently similar it may be difficult to distinguish between these entities despite a disparate underlying pathogenesis. Myopericarditis is primarily an inflammatory disease associated with high C-reactive protein (CRP) and relatively low elevated troponin concentrations, while AMI is characterized by the opposite. We hypothesized that evaluation of the CRP/troponin ratio on presentation to the emergency department could improve the differentiation between these two related clinical entities whose therapy is different. Such differentiation should facilitate triage to appropriate and expeditious therapy. Methods We evaluated the CRP/troponin ratio on presentation among patients consecutively included in a large single center registry that included 1898 consecutive patients comprising 1025 ST-elevation myocardial infarction (STEMI) patients, 518 Non-STEMI (NSTEMI) patients, and 355 patients diagnosed on discharge as myopericarditis. CRP and troponin were sampled on admission in all patients and their ratio was assessed against discharge diagnosis. ROC analysis of the CRP/troponin ratios evaluated the diagnostic accuracy of myopericarditis against all AMI, STEMI, and NSTEMI patients. Results Median admission CRP/troponin ratios were 84, 65, and 436 mg×ml/liter×ng in STEMI, NSTEMI and myopericarditis groups, respectively (p<0.001) demonstrating good differentiating capability. The Receiver-operator-curve of admission CRP/troponin ratio for diagnosis of myopericarditis against all AMI, STEMI, and NSTEMI patients yielded an area-under-the curve of 0.74, 0.73, and 0.765, respectively. CRP/troponin ratio>500 resulted in specificity exceeding 85%, and for a ratio>1000, specificity>92%. Conclusion The CRP/troponin ratio can serve as an effective tool to differentiate between myopericarditis and AMI. In the appropriate clinical context, the CRP/troponin ratio may preclude further evaluation.

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