University Hospital Essen, Medical Faculty, West German Heart and Vascular Center, Department of Cardiology and Vascular Diseases, Hufelandstr. 55, 45147 Essen, Germany.
University of Medicine and Pharmacy Carol Davila - University and Emergency Hospital, Cardiac Research Unit, Splaiul Independentei 169, 050098 Bucharest, Romania.
Sci Rep. 2017 Jan 27;7:41530. doi: 10.1038/srep41530.
Risk assessment in patients with acute coronary syndromes (ACS) is critical in order to provide adequate treatment. We performed a systematic meta-analysis to assess the predictive role of serum C-reactive protein (CRP) in patients with ST-segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention (PPCI). We included 7 studies, out of 1,033 studies, with a total of 6,993 patients with STEMI undergoing PPCI, which were divided in the high or low CRP group, according to the validated cut-off values provided by the corresponding CRP assay. High CRP values were associated with increased in-hospital and follow-up all-cause mortality, in-hospital and follow-up major adverse cardiac events (MACE), and recurrent myocardial infarction (MI). The pre-procedural CRP predicted in-hospital target vessel revascularization (TVR), but was not associated with acute/subacute and follow-up in-stent restenosis (ISR), and follow-up TVR. Thus, pre-procedural serum CRP could be a valuable predictor of global cardiovascular risk, rather than a predictor of stent-related complications in patients with STEMI undergoing PPCI. This biomarker might have the potential to improve the management of these high-risk patients.
在急性冠状动脉综合征（ACS）患者中进行风险评估对于提供充分的治疗至关重要。我们进行了一项系统的荟萃分析，以评估血清 C 反应蛋白（CRP）在接受直接经皮冠状动脉介入治疗（PPCI）的 ST 段抬高型心肌梗死（STEMI）患者中的预测作用。我们纳入了 7 项研究，共纳入了 6993 例接受 PPCI 的 STEMI 患者，根据相应 CRP 检测的验证截止值，将患者分为高或低 CRP 组。高 CRP 值与住院期间和随访期间全因死亡率、住院期间和随访期间主要不良心脏事件（MACE）以及复发性心肌梗死（MI）增加相关。术前 CRP 预测住院期间靶血管血运重建（TVR），但与急性/亚急性和随访支架内再狭窄（ISR）以及随访 TVR 无关。因此，术前血清 CRP 可能是评估接受 PPCI 的 STEMI 患者整体心血管风险的有价值的预测指标，而不是支架相关并发症的预测指标。这种生物标志物可能有潜力改善这些高危患者的管理。
