Correlation Between C-Reactive Protein And Left Ventricular Ejection Fraction InN Anterior ST Elevation Myocardial Infarction

https://doi.org/10.22146/acta%20interna.3871

Rosa Priambodo(1*)

(1) 
(*) Corresponding Author

Abstract


ABSTRACT

Background:  C-Reactive  Protein (CRP)  levels  were  found  increase  in  ST  elevation myocardial  infarction (STEMI) patients, before and after STEMI. Increase of CRP levels were able to activate complement pathway to induce inflammation by attracting neutrophil and macrophage to enter to infarcted myocardial.  Infarct expansion followed by remodeling process, led to left ventricular dysfunction and decrease of ejection fraction.

Aim: This study aimed to investigate a correlation between CRP plasma levels and left ventricular ejection fraction (LVEF) in anterior STEMI patients.

Subject and method: This study was conducted cross-sectionally. Subjects were new anterior STEMI patients, with maximum onset of 48 hours. Exclusion criteria included  evidence of infection, inflammation, history of surgery or stroke in last three months, malignancy, congestive heart failure and inferior STEMI. There were 30 subjects who met  the eligible criteria. CRP blood samples were collected at least 48 hours after onset.  LVEF measurement was done during   hospitalization. The correlation between CRP levels and LVEF was analyzed by Spearman rank correlation test.

Result: CRP levels in female subjects were higher than males [CRP median 23.4 mg/l (5.73 – 61.4 mg/l) vs. 12. 2 mg/l (5.6 – 66.5 mg/l)], but with no significance (P= 0.297). The thrombolytic therapy group had lower CRP levels than non thrombolytic therapy group [10. 7 mg/l (5.6 – 44.5 mg/l) vs. 14.7 mg/l (8.7 – 66.5 mg/l), also with no significance (P= 0.178). There was a non-significantly negative correlation between CRP level and LVEF (r = - 0.100, P= 0.597).

Conclusion: There was no correlation between CRP level and LVEF in anterior STEMI.


Full Text:

PDF


References

Fruchart, J.C. 2003. Atherosclerosis: an Inflammatory Disease? International

Task Force for Prevention of Coronary Heart Disease. Task Force Symposium

Anzai, T., Yoshikawa, T., Shiraki, H., Asakura, Y., Akaishi, M., Mitamura, H., Ogawa, S. 1997. C-Reactive Protein as a Predictor of Infarct Expansion and Cardiac Rupture After a First Q-Wave Acute Myocardial Infarction. Circulation. 96: 778-784

Suleiman, M., Aronson, D., Reisner, S.A., Kapeliovich, M.R., Markiewicz, W., Levy, Y., Hammerman, H. 2003. Admission C-Reactive Protein Levels and 30- Day Mortality in Patients with Acute Myocardial Infarction. Am. J. Med. 115:695-701

Hirschfield, G.M., Pepys, M.B., 2003. C-Reactive Protein and Cardiovascular

Disease: New Insight from an Old Molecule. Q. L. Med.. 96: 793 – 807

Griselli, M., Herbert, J., Hutchinson, W.L., Taylor, K.M., Sohail, M., Krausz, T., Pepys, M.B. 1999. C-Reactive Protein and Complement are Important Mediators of Tissue Damage in Acute Myocardial Infarction. J Exp Med. 190: 1733-1739

Lagrand, W.K., Niessen, H.W.M., Wolbink, G.J., Jaspars, L.H., Visser, C.A., Verheugt, F.W.A, Meijer, C.J.L.M., Hack, C.E. 1997. C-Reactive Protein Colocalizes With Complement in Human Hearts During Acute Myocardial Infarction. Circulation. 95: 97-103

Antman, E.M., Braunwald, E.1997. Acute Myocardial Infarction. in: E. Braunwald (editor) Heart Disease. A Textbook of Cardiovascular Medicine. 5th edition. W. B. Saunders Company. page: 1233-1241.

McMurray, J.V., McDonagh, T.A., Davie, A.P.1998. Should We Screen for Asymptomatic Left Ventricular Dysfunction to Prevent Heart Failure ? Eur Heart J. 19: 842-846.

DeMaria, A.N., Blanchard, D.G.1998. The Echocardiogram. in: R.W. Alexander. R.C. Schlant. V. Fuster. R.A. O’Rourke. R. Roberts. E.H. Sonnenblick (editor) Hurst’s The Heart. Arteries and Veins. vol. 1. 9th edition. Mc Graw-Hill. page: 415-517.

Galasko, G.I.W., Basu, S., Lahiri, A., Senior, R. 2004. Is Echocardiography a Valid Tool to Screen for Left Ventricular Systolic Dysfunction in Chronic Survivors of Acute Myocardial Infarction? A Comparison With Radionuclide Ventriculography. Heart. 90: 1422-1426.

Podrid, P.2004. C-Reactive Protein in Cardiovascular Disease-I. in: B.D. Rose (editor). UptoDate 12.2 edition. UptoDate. Wellesley. M.A

Tice, J.A., Browner, W., Tracy, R.P., Cummings, S.R.2003. The Relation of C- Reactive Protein Levels to Total and Cardiovascular Mortality in Older U. S. Women. Am. J. Med.114: 119-205.

Patel, V.B., Robbins, M.A., Topol, E.J. 2001. C-Reactive Protein: A Golden Marker for Inflammation and Coronary Artery Disease. Cleveland Clinic Journal of Medicine. Vol. 68. No. 6: 521-534

Ridker, P.M., Hennekens, C.H., Rifai, N., Buring, J.E., Manson, J.E.1999. Hormone Replacement Therapy and Increased Plasma Concentration of C-Reactive Protein. Circulation. 100: 713-71.

Zairis, M.N., Manousakis, S.J., Stefanidis, A.S., Papadaki, O.A., Andrikopulos, G.K., Olympios, C.D., Hadjissavas, J.J., Argyrakis, S.K., Foussas, S.G. 2002. C- Reactive Protein Levels on Admission Are Associated With Response to Thrombolysis and Prognosis After ST-segment Elevation Acute Myocardial Infarction. Am Heart J . 144: 782-789.

Pandian, S., Amuthan, V., Sukumar, P., Janarthanan, R.A., Murugan, S., Palanichamy, S., Subramaniam, G., Annamatai, M. 2005. Plasma CRP Level Predicts Left Ventricular Function and Exercise Capacity in Patients With Acute Myocardial Infarction. Indian Heart Journal. 57: 54-57.

Tommasi, S., Carluccio, E., Bentivoglio, M., Buccolieri, M., Mariotti, M., Politano, M., Corea, L.1999. C-Reactive Protein as a Marker for Cardiac Ischemic Events in the Year After a First. Uncomplicated Myocardial Infarction. Am J Cardiol. 83:1595-1599.

Kimura, K., Kosuge, M., Ishikawa, T., Shimizu, M., Endo, T., Hongo, Y., Tochikubo, O., Umemura, S. 2001. Relationship Between Myocardial Damage and C-Reactive Protein Levels Immediately After Onset of Acute Myocardial Infarction. Jpn Circ J. 65: 67-70.



DOI: https://doi.org/10.22146/acta%20interna.3871

Article Metrics

Abstract views : 851 | views : 949

Refbacks

  • There are currently no refbacks.




Copyright (c) 2012 Acta Interna The Journal of Internal Medicine

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Acta Interna The Journal of Internal Medicine Indexed by:

 

 Indonesia Onesearch Google Scholar IPI Indonesian Publication Index

 website statistics View My Stats  

 

 

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.