Mouridsen Mette Rauhe, Intzilakis Theodoros, Binici Zeynep, Nielsen Olav Wendelboe, Sajadieh Ahmad
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, Copenhagen NV, Denmark.
J Electrocardiol. 2012 May-Jun;45(3):260-4. doi: 10.1016/j.jelectrocard.2011.11.004. Epub 2012 Jan 2.
The aim of this study was to evaluate the prognostic value of high sensitive C-reactive protein (CRP) in subjects with silent myocardial ischemia (SMI).
In total, 678 healthy men and women aged 55 to 75 years with no history of cardiovascular disease or stroke were included. High-sensitive CRP and 48-hour ambulatory ECG monitoring were performed. The primary endpoint was the combined endpoint of death and myocardial infarction.
The median follow-up time was 76 months. Seventy-seven subjects (11.4%) had SMI. The combined endpoint occurred in 26% of the subjects with SMI and 14% of the subjects without SMI (P = .005). SMI had a poor prognosis in the group with an elevated CRP ≥ 3.0 μg/mL (hazard ratio, 3.46; 95% confidence interval, 1.67-7.16; P = .001) compared with the group of subjects with SMI and a low CRP <3.0 μg/mL (hazard ratio, 1.37; 95% confidence interval, 0.63-2.98; P = .54).
In apparently healthy subjects, a low level of CRP <3.0 μg/mL selects a low-risk subgroup, despite the presence of SMI.
本研究旨在评估高敏C反应蛋白（CRP）在无症状心肌缺血（SMI）患者中的预后价值。
总共纳入了678名年龄在55至75岁之间、无心血管疾病或中风病史的健康男性和女性。进行了高敏CRP检测和48小时动态心电图监测。主要终点是死亡和心肌梗死的联合终点。
中位随访时间为76个月。77名受试者（11.4%）患有SMI。联合终点在26%的SMI患者和14%的非SMI患者中出现（P = .005）。与CRP <3.0 μg/mL的SMI患者组相比，CRP≥3.0 μg/mL的SMI患者组预后较差（风险比，3.46；95%置信区间，1.67 - 7.16；P = .001）（CRP <3.0 μg/mL的SMI患者组风险比，1.37；95%置信区间，0.63 - 2.98；P = .54）。
在看似健康的受试者中，尽管存在SMI，但CRP水平<3.0 μg/mL可筛选出低风险亚组。
