Concomitant Impact of High-Sensitivity C-Reactive Protein and Renal Dysfunction in Patients with Acute Myocardial Infarction.
10.3349/ymj.2014.55.1.132
- Author:
Yong Un KANG
1
;
Min Jee KIM
;
Joon Seok CHOI
;
Chang Seong KIM
;
Eun Hui BAE
;
Seong Kwon MA
;
Young Keun AHN
;
Myung Ho JEONG
;
Young Jo KIM
;
Myeong Chan CHO
;
Chong Jin KIM
;
Soo Wan KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. skimw@chonnam.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
C-reactive protein;
glomerular filtration rate;
myocardial infarction
- MeSH:
Aged;
C-Reactive Protein/*metabolism;
Coronary Angiography;
Female;
Humans;
Kidney/*physiopathology;
Male;
Middle Aged;
Myocardial Infarction/*metabolism/*radiography;
Retrospective Studies
- From:Yonsei Medical Journal
2014;55(1):132-140
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The present study aimed to investigate the impact of high-sensitivity C-reactive protein (hs-CRP) and renal dysfunction on clinical outcomes in acute myocardial infarction (AMI) patients. MATERIALS AND METHODS: The study involved a retrospective cohort of 8332 patients admitted with AMI. The participants were divided into 4 groups according to the levels of estimated glomerular filtration rate (eGFR) and hs-CRP: group I, no renal dysfunction (eGFR > or =60 mL.min(-1).1.73 m(-2)) with low hs-CRP (< or =2.0 mg/dL); group II, no renal dysfunction with high hs-CRP; group III, renal dysfunction with low hs-CRP; and group IV, renal dysfunction with high hs-CRP. We compared major adverse cardiac events (MACE) over a 1-year follow-up period. RESULTS: The 4 groups demonstrated a graded association with increased MACE rates (group I, 8.8%; group II, 13.8%; group III, 18.6%; group IV, 30.1%; p<0.001). In a Cox proportional hazards model, mortality at 12 months increased in groups II, III, and IV compared with group I [hazard ratio (HR) 2.038, 95% confidence interval (CI) 1.450-2.863, p<0.001; HR 3.003, 95% CI 2.269-3.974, p<0.001; HR 5.087, 95% CI 3.755-6.891, p<0.001]. CONCLUSION: High hs-CRP, especially in association with renal dysfunction, is related to the occurrence of composite MACE, and indicates poor prognosis in AMI patients.