Vol. 77, September 2009

High Sensitive C-Reactive Protein as a Predictor of Acute Heart Failure in Acute Myocardial Infarction

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High Sensitive C-Reactive Protein as a Predictor of Acute Heart Failure in Acute Myocardial Infarction, AHMAD M. FAREED, GAMILA M. NASR, OLA F. LEHETA and AHMAD A. ELHAWARY

 

Abstract
Background: The development of heart failure in the setting of acute myocardial infarction (AMI) results in signif-icant risk far above that of AMI. Independently CRP level in the early phase of MI might be a simple marker for the magnitude of the inflammatory response to myocardial necro-sis, potentially providing prognostic information regarding the risk of death and HF. However, it is not known whether inflammation plays a role in the time-course of heart failure (HF) in this clinical setting. Our aim was to study the rela-tionship between high CRP levels and HF progression during the first week of hospitalization for AMI.
Methods: This study included 59 patients admitted with acute myocardial infarction to the coronary care unit of the Suez Canal University hospital. CRP was assessed on the first, third and seventh day after admission.
Results: 42% of the study population developed heart failure. Among the patients with AMI, CRP was significantly higher in patients with HF than in patients without HF at admission, after 48 hours and after 7 days of admission (p=0.0001 & p=0.000 and p=0.001 respectively). Prevalence of HF was significantly higher on admission in patients with initial CRP serum level >!17mg/L. CRP levels after 48 hours of admission showed significant positive correlation with peak CKMB (p=0.02) and peak CK levels (p=0.002) but they showed significant negative correlation with left ventricular ejection fraction (p=0.01).
Conclusions: On admission, hs-CRP level is a strong predictor of the incidence of heart failure in AMI setting. Hs-CRP is a good predictor of the amount of myocardial damage in AMI and it may predict the left ventricular ejection fraction after AMI.

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