Abstract:
Elevated high sensitivity C-reactive protein (hs-CRP) levels are associated with
coronary artery disease, and raised basal hs-CRP concentration is associated with
higher risk of complications of acute myocardial infarction (AMI). The aim of this
work was to find out the relationship between hs-CRP and complications of AMI
in our setting. Two hundred and six males; 103 patients with first acute ST elevation myocardial infarction (STEMI) admitted to Coronary Care Unit,
Teaching Hospital Karapitiya and 103 controls without coronary artery disease
were studied. The complications of STEMI, occurred during the hospital-stay were
recorded. Serum basal hs-CRP was estimated by turbidimetry. Continuous
variables were compared with two sample-t test, and binary logistic regression was
used in the analysis of predictors of in-hospital complications. During the hospital
stay, 50 (48.5%) patients developed complications, but no deaths were reported.
Heart failure was the most common in–hospital complication with 34 (33.0%)
patients affected. There were 18 (17.4%) patients with rhythm abnormalities of
which four (3.9%) had ventricular fibrillation, nine (8.7%) patients developed
mural thrombus and four (3.8%) had cardiogenic shock. The hs-CRP concentration
was significantly higher in patients with STEMI than in controls (3.7±0.84 mg/L
vs. 1.7±0.60 mg/L, p=0.001). The hs-CRP concentration was higher in STEMI
patients with complications compared to those without complications (4.0±0.95
mg/L vs. 3.60±0.69 mg/L, p=0.016). On admission, basal serum hs-CRP (p=0.019,
OR=1.85, 95% CI=1.11-3.08), serum cTnI (p=0.030, OR=1.01, 95 % CI=1.00-
1.02) and left ventricular ejection fraction (p=0.001, OR=0.9, CI= 0.85-0.95) were
strong independent predictors of STEMI complications. On admission (basal)
serum hs-CRP concentration was significantly higher in patients compared to
controls and was suitable for predicting the complications of STEMI during the
hospital stay.
