Association between admission serum high sensitivity C-reactive protein concentration and risk of developing complications following acute myocardial infarction, in men admitted to a tertiary care centre

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.