Al Aseri Zohair A, Habib Syed Shahid, Marzouk Ameer
Department of Emergency Medicine, King Saud University & Medical City, Riyadh, Saudi Arabia.
Department of Physiology, King Saud University & Medical City, Riyadh, Saudi Arabia.
Vasc Health Risk Manag. 2019 Jul 15;15:221-227. doi: 10.2147/VHRM.S198452. eCollection 2019.
High sensitivity C-reactive protein (hsCRP) predicts myocardial dysfunction after acute coronary syndromes. We aimed to study the association of hsCRP estimation at first acute myocardial infarction (AMI) with myocardial dysfunction and heart failure. This research was carried out at the Department of Physiology and Department of Emergency Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. In this prospective study, 227 patients were studied. hsCRP levels were estimated when patients came to the emergency department at AMI, 7 days post AMI, and at 12 weeks of follow up after AMI. The outcome was change in myocardial functions, especially heart failure, 12 months after the attack. Based on a cutoff mean value of hsCRP levels at admission (10.05±12.68 mg/L), patients were grouped into high and low C-reactive protein (CRP.) The ejection fraction was significantly lower at follow up in the high CRP group (37.29±12.97) compared to the low CRP group (43.85±11.77, <0.0198). hsCRP had significant inverse correlation with left ventricular ejection fraction (r=-0.283, <0.01). About 38.1% patients showed heart failure, with 23.6% in the high CRP group and 14.5% in the low CRP group (OR 2.4, =0.028). Receiver operating characteristic curve analysis showed that CRP levels at AMI had a specificity of 79% and sensitivity of 83% to predict heart failure. A high hsCRP level measured at first AMI predicts myocardial dysfunction and heart failure. It is suggested that hsCRP plays an important role in the development of heart failure after myocardial infarction.
高敏C反应蛋白（hsCRP）可预测急性冠脉综合征后的心肌功能障碍。我们旨在研究首次急性心肌梗死（AMI）时hsCRP评估值与心肌功能障碍及心力衰竭之间的关联。本研究在沙特阿拉伯利雅得国王沙特大学国王哈立德大学医院的生理学系和急诊科开展。在这项前瞻性研究中，对227例患者进行了研究。在患者因AMI到达急诊科时、AMI后7天以及AMI后12周的随访时测定hsCRP水平。观察的结果是发作后12个月时心肌功能的变化，尤其是心力衰竭情况。根据入院时hsCRP水平的截断均值（10.05±12.68 mg/L），将患者分为高C反应蛋白（CRP）组和低CRP组。与低CRP组（43.85±11.77，<0.0198）相比，高CRP组随访时的射血分数显著更低（37.29±12.97）。hsCRP与左心室射血分数呈显著负相关（r=-0.283，<0.01）。约38.1%的患者出现心力衰竭，高CRP组为23.6%，低CRP组为14.5%（比值比2.4，=0.028）。受试者工作特征曲线分析表明，AMI时的CRP水平预测心力衰竭的特异性为79%，敏感性为83%。首次AMI时测得的高hsCRP水平可预测心肌功能障碍和心力衰竭。提示hsCRP在心肌梗死后心力衰竭的发生中起重要作用。
