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Association of peak C-reactive protein with long-term clinical outcomes in patients with ST-segment elevation myocardial infarction

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Abstract

Peak C-reactive protein (CRP) levels following ST-segment elevation myocardial infarction (STEMI) are associated with left ventricular thrombus formation or cardiac rupture. However, the impact of peak CRP on long-term outcomes in patients with STEMI is not completely understood. The purpose of this retrospective study was to compare the long-term all-cause death after STEMI between patients with and without high peak CRP levels. We included 594 patients with STEMI, and divided them into the high CRP group (n = 119) and the low-moderate CRP group (n = 475) according to the quintile of peak CRP levels. The primary endpoint was all-cause death after the discharge of the index admission. The mean peak CRP level was 19.66 ± 5.14 mg/dL in the high CRP group, whereas that was 6.43 ± 3.86 mg/dL in the low-moderate CRP group (p < 0.001). During the median follow-up duration of 1045 days (Q1 284 days, Q3 1603 days), a total of 45 all-cause deaths were observed. The Kaplan–Meier curves showed that all-cause death was more frequently observed in the high CRP group than in the low-moderate CRP group (p = 0.002). The multivariate Cox hazard analysis revealed that high CRP was significantly associated with all-cause death (hazard ratio 2.325, 95% confidence interval 1.246–4.341, p = 0.008) after controlling for confounding factors. In conclusion, high peak CRP was significantly associated with all-cause death in patients with STEMI. Our results suggest that peak CRP may be useful to stratify patients with STEMI for the risk of future death.

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Data availability

The data that support the findings of this study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge all the staff in the catheter laboratory, cardiology units, and emergency and intensive care units in Saitama Medical Center, Jichi Medical University for their technical support in this study.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama City, 330-8503, Japan

    Yoichi Hori, Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Takunori Tsukui, Yusuke Watanabe, Kei Yamamoto, Masaru Seguchi, Hiroshi Wada & Hideo Fujita

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  1. Yoichi Hori
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  2. Kenichi Sakakura
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  3. Hiroyuki Jinnouchi
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  4. Yousuke Taniguchi
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  5. Takunori Tsukui
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  6. Yusuke Watanabe
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  7. Kei Yamamoto
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  8. Masaru Seguchi
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  9. Hiroshi Wada
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  10. Hideo Fujita
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Correspondence to Kenichi Sakakura.

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Conflict of interest

Dr. Sakakura has received speaking honoraria from Abbott Vascular, Boston Scientific, Medtronic Cardiovascular, Terumo, OrbusNeich, Japan Lifeline, Kaneka, and NIPRO. Dr. Jinnouchi has received speaking honoraria from Abbott Vascular. Prof. Fujita has served as a consultant for Mehergen Group Holdings, Inc.

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Hori, Y., Sakakura, K., Jinnouchi, H. et al. Association of peak C-reactive protein with long-term clinical outcomes in patients with ST-segment elevation myocardial infarction. Heart Vessels 38, 764–772 (2023). https://doi.org/10.1007/s00380-023-02250-z

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  • DOI: https://doi.org/10.1007/s00380-023-02250-z

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