C反应蛋白作为急性心肌梗死患者左心室血栓形成的危险因素。

C-Reactive protein as a risk factor for left ventricular thrombus in patients with acute myocardial infarction.

作者信息

Celik S, Baykan M, Erdöl C, Kilinç K, Orem A, Orem C, Durmus I

机构信息

KTU Faculty of Medicine, Department of Cardiology, Trabzon, Turkey.

出版信息

Clin Cardiol. 2001 Sep;24(9):615-9. doi: 10.1002/clc.4960240909.

DOI:10.1002/clc.4960240909

PMID:11558844

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6654960/

Abstract

BACKGROUND

Elevated C-reactive protein (CRP) has been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that CRP may be involved in initiation process of coagulation; however, the role of CRP level in the formation of left ventricular (LV) thrombus has not been studied.

HYPOTHESIS

This study investigated whether CRP is a risk factor for LV thrombus in patients with AMI.

METHODS

Clinical, echocardiographic, and biochemical data were analyzed in 141 consecutive patients (aged 57 +/- 13 years; 33 women) with first anterior AMI. Two-dimensional and Doppler echocardiographic examinations were performed on Days 1, 3, 7, 15, and 30. Blood samples were obtained every day during hospitalization. Serum CRP concentrations were measured by an ultrasensitive immunonephelometry method.

RESULTS

Left ventricular thrombus was detected in 33 (23.4%) patients. Univariate analysis showed that patients with LV thrombus had a higher peak creatine kinase (CK) level (2,879 +/- 742 vs. 1,693 +/- 1,210 I/U, p = 0.001), higher peak CRP level (14.9 +/- 7.1 vs. 9.2 +/- 6.8 mg/dl, p = 0.001), higher wall motion score index (1.8 +/- 0.2 vs. 1.5 +/- 0.3, p = 0.002), higher apical wall motion score index (2.35 +/- 0.72 vs. 2.07 +/- 0.70, p = 0.001), larger end-diastolic volume (145.2 +/- 43.7 vs. 116.5 +/- 44.2 ml, p = 0.002), larger end-systolic volume (85.4 +/- 37.2 vs. 62.9 +/- 31.6 ml, p = 0.003), and lower ejection fraction (42.1 +/- 12 vs. 47.3 +/- 13, p = 0.04). In multivariate analyses, only peak CK level (p = 0.0001), LV apical wall motion score index (p = 0.001), and CRP levels (p = 0.001) were independent predictors of LV thrombus formation.

CONCLUSIONS

These results suggest that CRP is a risk factor for LV thrombus in patients with AMI.

摘要

背景

研究发现，急性心肌梗死（AMI）患者中，C反应蛋白（CRP）升高与心脏事件风险增加相关。有人提出，CRP可能参与凝血起始过程；然而，CRP水平在左心室（LV）血栓形成中的作用尚未得到研究。

假设

本研究调查了CRP是否为AMI患者LV血栓形成的危险因素。

方法

对141例连续的首次前壁AMI患者（年龄57±13岁；33例女性）的临床、超声心动图和生化数据进行分析。在第1、3、7、15和30天进行二维和多普勒超声心动图检查。住院期间每天采集血样。采用超敏免疫比浊法测定血清CRP浓度。

结果

33例（23.4%）患者检测到LV血栓。单因素分析显示，LV血栓患者的肌酸激酶（CK）峰值水平较高（2,879±742 vs. 1,693±1,210 I/U，p = 0.001）、CRP峰值水平较高（14.9±7.1 vs. 9.2±6.8 mg/dl，p = 0.001）、壁运动评分指数较高（1.8±0.2 vs. 1.5±0.3，p = 0.002）、心尖壁运动评分指数较高（2.35±0.72 vs. 2.07±0.70，p = 0.001）、舒张末期容积较大（145.2±43.7 vs. 116.5±44.2 ml，p = 0.002）、收缩末期容积较大（85.4±37.2 vs. 62.9±31.6 ml，p = 0.003），射血分数较低（42.1±12 vs. 47.3±第13，p = 0.04）。多因素分析中，只有CK峰值水平（p = 0.0001）、LV心尖壁运动评分指数（p = 0.001）和CRP水平（p = 0.001）是LV血栓形成的独立预测因素。