C 反应蛋白在预测首次 ST 段抬高型心肌梗死患者左心室重构中的价值。
Value of C-reactive protein in predicting left ventricular remodelling in patients with a first ST-segment elevation myocardial infarction.
机构信息
Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
出版信息
Mediators Inflamm. 2012;2012:250867. doi: 10.1155/2012/250867. Epub 2012 Sep 2.
OBJECTIVE
To assess the value of C-reactive protein (CRP) in predicting postinfarct left ventricular remodelling (LVR).
METHODS
We measured in-hospital plasma CRP concentrations in patients with a first ST-segment elevation myocardial infarction (STEMI).
RESULTS
LVR was present at 6 months in 27.8% of 198 patients. CRP concentration rose during the first 24 h, mainly in LVR group. The prevalence of LVR was higher in patients from the highest quartile of CRP concentrations at 24 h as compared to those from any other quartile (odds ratio (OR) 3.48, 95% confidence interval (95% CI) 1.76-6.88). Multivariate analysis identified CRP concentration at 24 h (OR for a 10 mg/L increase 1.29, 95% CI 1.04-1.60), B-type natriuretic peptide at discharge (OR for a 100 pg/mL increase 1.21, 95% CI 1.05-1.39), body mass index (OR for a 1 kg/m(2) increase 1.10, 95% CI 1.01-1.21), and left ventricular end-diastolic volume (OR for a 1 mL increase 0.98, 95% CI 0.96-0.99) as independent predictors of LVR. The ROC analysis revealed a limited discriminative value of CRP (area under the curve 0.61; 95% CI 0.54-0.68) in terms of LVR prediction.
CONCLUSIONS
Measurement of CRP concentration at 24 h after admission possesses a significant but modest value in predicting LVR after a first STEMI.
目的
评估 C 反应蛋白（CRP）在预测梗死后左心室重构（LVR）中的价值。
方法
我们测量了首次 ST 段抬高型心肌梗死（STEMI）患者住院期间的血浆 CRP 浓度。
结果
198 例患者中有 27.8%在 6 个月时存在 LVR。CRP 浓度在最初 24 小时内升高，主要在 LVR 组中。与任何其他四分位数相比，24 小时 CRP 浓度最高四分位数的患者 LVR 发生率更高（优势比（OR）3.48，95%置信区间（95%CI）1.76-6.88）。多变量分析确定了 24 小时 CRP 浓度（每增加 10mg/L 的 OR 为 1.29，95%CI 为 1.04-1.60）、出院时 B 型利钠肽（OR 每增加 100pg/mL 的 OR 为 1.21，95%CI 为 1.05-1.39）、体重指数（OR 每增加 1kg/m2 的 OR 为 1.10，95%CI 为 1.01-1.21）和左心室舒张末期容积（OR 每增加 1mL 的 OR 为 0.98，95%CI 为 0.96-0.99）是 LVR 的独立预测因子。ROC 分析显示 CRP 在预测 LVR 方面的区分能力有限（曲线下面积 0.61；95%CI 0.54-0.68）。
结论
入院后 24 小时 CRP 浓度测量对首次 STEMI 后 LVR 预测具有重要但适度的价值。
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