C-reactive protein levels as an early predictor of 30-day mortality in patients with acute myocardial infarction

Abstract

Background: In patients with unstable angina, elevated C-reactive protein (CRP) has been shown to predict recurrent coronary events. However, little data is available on the prognostic value of CRP in acute myocardial infarction (AMI), and its relation to measures of infarct size. Methods: CRP was measured within 24-h of symptoms onset in a prospective series of 348 consecutive patients (mean age 62 + 13 y, men 76%) with AMI (260 with ST-elevation AMI). Echocardiographic examination was performed on day 2 or 3. Thirty-day mortality was evaluated using Cox proportional-hazards model wtth the following covariates: age, gender, prior aspirin use, Killip class, diabetes, peak CK. SBP 2.2 mg/UL) had higher peak CK (1999 t 166 vs 1762 * 116, p = 0.01) and higher echocardiographic wall motion score index (1.6 * 0.4 vs 1.5 + 0.4, p < 0.0001). Kaplan-Meier surwal wives indicated that patients with CRP levels in the upper tertile were at Increased risk of 30.day mortality (Figure). In a Cox’s multivariate analysis, CRP level in the upper tertile was a significant and independent predictor of 30-day mortality (Relative Risk = 3.2, 95% Cl 1.2-6.2, p = 0.007). Conclusion: CRP level on admission is a powerful predictor of 30-day mortality in patients with AMI independent of infarct size and other traditional predictors of outcome.