Project Description

Background: Several studies have shown the independent association of high plasma C-reactive protein (CRP) levels with an adverse prognosis in patients with acute myocardial infarction. However, the possible association of plasma CRP levels with response to thrombolysis and short- and long-term cardiac mortality has not been investigated. The aim of this study was to evaluate these possible associations.

Methods: Three hundred nineteen consecutive patients who received intravenous thrombolysis because of ST-segment elevation acute myocardial infarction were prospectively studied. Patients were classified according to tertiles of plasma CRP levels on admission.

Results: Patients at the top tertile had a significantly lower incidence of complete ST-segment resolution (third vs first, P
.001, third vs second, P  .009) or Thrombolysis In Myocardial Infarction (TIMI) 3 flow in the infraction-related artery (third vs first, P
.001, third vs second, P  .02), more compromised left ventricular function (third vs first, P  .02, second vs third, P  .04), greater inhospital mortality (third vs first, P  .03, third vs second, P  .06), and greater 3-year cardiac mortality (third vs first, P  .01, third vs second, P  .07).

Conclusions: Plasma levels of CRP on admission may be a predictor of reperfusion failure and of short- and longterm prognosis in patients with ST-segment elevation acute myocardial infarction. (Am Heart J 2002;144:782-9.)