Liu Shijie, Jiang Hongcheng, Dhuromsingh Menaka, Dai Lei, Jiang Yue, Zeng Hesong
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, China.
Front Cardiovasc Med. 2022 Nov 16;9:1013501. doi: 10.3389/fcvm.2022.1013501. eCollection 2022.
BACKGROUND: Proper prognostic biomarker is of great importance for clinical decision-making in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Although recently emerges plenty of novel inflammatory biomarkers, the canonical inflammatory mediator C-reactive protein still plays an important role in prognosing adverse post-infarction complications. METHODS: PubMed, Embase, and Medline were systematically searched from the establishment of databases up to December 2021, conforming with standards set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: A total of 23 studies were eventually eligible for this meta-analysis, including 18,715 individuals. Our findings showed that elevated C-reactive protein (CRP) had a statistically significant superiority in predicting all-cause mortality (OR: 3.22, 95% CI: [2.71, 3.84], < 0.00001), cardiovascular death (OR: 3.26, 95% CI: [2.30, 4.61], < 0.00001), major adverse cardiovascular events (MACEs) (OR: 2.85, 95% CI [2.08, 3.90], < 0.00001), heart failure (OR: 2.29, 95% CI: [1.48, 3.54], = 0.0002), recurrent myocardial infarction (OR: 1.76, 95% CI: [1.28, 2.43], < 0.001), and restenosis (OR: 1.71, 95% CI: [1.18, 2.47], = 0.004). Subgroup analysis implies that CRP had better performance in predicting plenty of hospitalization and short-term (<12 months) adverse prognosis than long-term prognosis and Asian patients with elevated CRP were under more risk in adverse prognosis after PCI than Europeans. CONCLUSION: Our meta-analysis suggests that CRP is a prospective predictor of the prognosis in patients with AMI undergoing PCI, especially in hospitalization and short-term and in the Asian group.
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