Abstract 068: High Sensitivity C-reactive Protein Levels Among Patients With Myocardial Infarction: Insights From Triumph

Abstract

Background: Elevated hs-CRP has been shown to correlate with adverse outcomes in patients with coronary disease, however, little is known about the patterns of hs-CRP levels at the time of, and following, AMI. We sought to describe these patterns and patient characteristics associated with persistently elevated hs-CRP. Methods: TRIUMPH was a prospective observational AMI registry that assessed hs-CRP levels at baseline, 1 and 6 months after AMI. Patients were divided into groups based on their hs-CRP levels at baseline and follow up (1 and 6 months) with elevated hs-CRP defined as ≥ 2 mg/L. Results: Among patients with available baseline and 1 month hs-CRP (n=801), 753 (94%) of patients had hs-CRP ≥2 at baseline, of which 427 (56.7%) still had hs-CRP ≥2 at 1 month (Figure). Of 48 patients with hs-CRP <2 at baseline, only 12 (25%) had elevated hs-CRP at 1 month. Among 434 patients with baseline and 6 months hs-CRP, 407 (93%) had elevated hs-CRP at baseline of which 195 (45%) still had elevated hs-CRP at 6 months. There were 247 patients with persistent elevation of hs-CRP at both1 and 6 months. Patients with elevated hsCRP at 1 month were more likely to be female, non-white, obese, smokers, with diabetes, hypertension, prior MI and with multi-vessel disease. Conclusions: Approximately half of patients with elevated hs-CRP at the time of an AMI have persistently elevated hs-CRP at 1 and 6 months. Further investigation is needed to better illuminate the optimal risk reduction strategies for this higher-risk cohort.