Association between C-reactive protein level and echocardiography assessed left ventricular function in first ST-segment elevation myocardial infarction patients who underwent primary coronary intervention.

BACKGROUND

An elevated C-reactive protein (CRP) level is associated with adverse outcomes in patients with acute myocardial infarction (AMI). Although CRP levels have been shown to be associated with left ventricular (LV) systolic function and remodeling in AMI, little is known about their relation to early LV diastolic function.

METHODS

We retrospectively studied 173 consecutive patients <75 years of age with first ST-segment elevation MI (STEMI) that was treated by primary percutaneous coronary intervention (PPCI). They had presented within 24h of chest pain onset and their CRP levels were determined within 6h of hospital admission. They all underwent echocardiography within 3 days of admission and were stratified by CRP tertiles.

RESULTS

The cut-off points for the CRP tertiles were <2.6 mg/L, 2.6-7.9 mg/L, and >7.9 mg/L. Patients with higher CRP levels had a significantly higher mean mitral inflow E wave velocity (68 ± 16 cm/s vs 77 ± 19 cm/s vs 76 ± 17 cm/s; p=0.02), a higher E/average e' (8.9 ± 1.9 vs 9.8 ± 2.8 vs 10.4±3.2; p=0.02), and a higher systolic pulmonary artery pressure (27 ± 6 mmHg vs 30 ± 8 mmHg vs 32 ± 10 mmHg; p=0.04). Elevated CRP levels were associated with more advanced diastolic dysfunction than normal CRP levels (p=0.04). The admission CRP level was an independent predictor of average E/e' ratio (multivariate analysis).

CONCLUSION

Admission CRP levels are associated with echocardiographic parameters of elevated LV filling pressure in patients with STEMI treated with PPCI.