Milwidsky Assi, Ziv-Baran Tomer, Letourneau-Shesaf Sevan, Keren Gad, Taieb Philippe, Berliner Shlomo, Shacham Yacov
a Department of Cardiology , Tel-Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel.
b Department of Epidemiology and Preventative Medicine , School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
Biomarkers. 2017 May-Jun;22(3-4):383-386. doi: 10.1080/1354750X.2017.1279218. Epub 2017 Jan 25.
There is a known association between C-reactive protein (CRP) levels and adverse outcomes in patients presenting with ST-elevation myocardial infarction (STEMI). The optimal time frame to measure CRP for risk stratification is not known.
The aim of the current study was to evaluate the relation between the change in CRP velocity (CRPv) and 30-d mortality among STEMI patients.
We included consecutive patients with a diagnosis of STEMI who presented to Tel-Aviv Medical Center between 2008 and 2014 and had their CRP measured with a wide range assay (wr-CRP) at least twice during the 24 h after admission. CRPv was defined as the change in wr-CRP concentration (mg/l) divided by the change in time (in hours) between the two measurements.
The study population comprised of 492 patients, mean age was 62 ± 14, 80% were male. CRPv was significantly higher among patients who died within 30 d of admission (1.42 mg/l versus 0.18 mg/l, p < 0.001). In a multivariate regression model adjusted to multiple confounders, CRPv was independently associated with 30-d mortality (OR 1.39, 95% CI: 1.20-1.62, p < 0.001).
CRPv might be an independent and rapidly measurable biomarker for short-term mortality in patients presenting with STEMI.
C反应蛋白（CRP）水平与ST段抬高型心肌梗死（STEMI）患者的不良预后之间存在已知关联。用于风险分层的CRP最佳测量时间框架尚不清楚。
本研究旨在评估STEMI患者CRP速度变化（CRPv）与30天死亡率之间的关系。
我们纳入了2008年至2014年期间在特拉维夫医疗中心就诊、诊断为STEMI且入院后24小时内至少两次采用宽范围检测法（wr-CRP）测量CRP的连续患者。CRPv定义为两次测量之间wr-CRP浓度变化（mg/l）除以时间变化（小时）。
研究人群包括492例患者，平均年龄为62±14岁，80%为男性。入院后30天内死亡的患者CRPv显著更高（1.42mg/l对0.18mg/l，p<0.001）。在调整了多个混杂因素的多变量回归模型中，CRPv与30天死亡率独立相关（OR 1.39，95%CI：1.20-1.62，p<0.001）。
CRPv可能是STEMI患者短期死亡率的一个独立且可快速测量的生物标志物。
