Abstract
Background: Elevated high sensitivity C-reactive protein (hs-CRP) in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) has prognostic value for future cardiovascular events. This study aimed to ascertain a valid prognostic time-period for predicting cardiovascular outcome based on baseline hs-CRP in AMI patients undergoing successful PCI on statin therapy. Methods: Overall, 4410 AMI patients were enrolled from the Korea Acute Myocardial Infarction-National Institutes of Health (KAMIR-NIH) registry. Participants were divided into groups according to cut-off values of baseline hs-CRP (1.0, 3.0, and 10.0 mg/L) and statin therapy intensity. The primary outcome was 36-month major adverse cardiovascular events (MACE), a composite of all-cause mortality, any myocardial infarction, and repeat revascularization. The secondary outcome was MACE developed 0–6, 6–12, and 12–36 months after AMI. Results: The overall incidence of 36-month MACE was significantly higher as baseline hs-CRP increased (by groups: 8.8% vs. 8.6% vs. 10.7% vs. 15.4%, log-rank p < 0.001). The prognostic effect of baseline hs-CRP was mostly confined to the first 6 months after AMI (0–6 months MACE by groups: 1.6% vs. 2.3% vs. 4.3% vs. 6.1%, log-rank p < 0.001) and attenuated in high-intensity statin users. Six months after AMI, this prognostic effect of baseline hs-CRP was remarkably reduced (6–12 month MACE by groups: 2.4% vs. 2.1% vs. 2.8% vs. 4.0%, log-rank p = 0.111, 12–36 month MACE by groups: 4.7% vs. 4.1% vs. 4.0% vs. 6.2%, log-rank p = 0.218); however, high-intensity statin treatment showed a consistent improvement in outcome. The observed time-dependent prognostic effects remained consistent following multivariate analysis. Conclusions: The prognostic impact of elevated hs-CRP at baseline was most evident during the first 6 months after AMI; however, the use of high-intensity statin persistently improved the clinical outcome even after the resolution of inflammatory reactions.
| Original language | English |
|---|---|
| Journal | Journal of Cardiology |
| DOIs | |
| Publication status | Published - 2019 Jan 1 |
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Keywords
- C-reactive protein
- Coronary artery disease
- Myocardial infarction
- Percutaneous coronary intervention
- Statins
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Time-dependent prognostic effect of high sensitivity C-reactive protein with statin therapy in acute myocardial infarction. / Kang, Dong Oh; Park, Yoonjee; Seo, Ji Hoon; Jeong, Myung Ho; Chae, Shung Chull; Ahn, Tae Hoon; Jang, Won Young; Kim, Woohyeun; Park, Eun Jin; Choi, Byoung Geol; Na, Jin Oh; Choi, Cheol Ung; Kim, Eung Ju; Rha, Seung-Woon; Park, Chang Gyu; Seo, Hong Seog.
In: Journal of Cardiology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Time-dependent prognostic effect of high sensitivity C-reactive protein with statin therapy in acute myocardial infarction
AU - Kang, Dong Oh
AU - Park, Yoonjee
AU - Seo, Ji Hoon
AU - Jeong, Myung Ho
AU - Chae, Shung Chull
AU - Ahn, Tae Hoon
AU - Jang, Won Young
AU - Kim, Woohyeun
AU - Park, Eun Jin
AU - Choi, Byoung Geol
AU - Na, Jin Oh
AU - Choi, Cheol Ung
AU - Kim, Eung Ju
AU - Rha, Seung-Woon
AU - Park, Chang Gyu
AU - Seo, Hong Seog
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Elevated high sensitivity C-reactive protein (hs-CRP) in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) has prognostic value for future cardiovascular events. This study aimed to ascertain a valid prognostic time-period for predicting cardiovascular outcome based on baseline hs-CRP in AMI patients undergoing successful PCI on statin therapy. Methods: Overall, 4410 AMI patients were enrolled from the Korea Acute Myocardial Infarction-National Institutes of Health (KAMIR-NIH) registry. Participants were divided into groups according to cut-off values of baseline hs-CRP (1.0, 3.0, and 10.0 mg/L) and statin therapy intensity. The primary outcome was 36-month major adverse cardiovascular events (MACE), a composite of all-cause mortality, any myocardial infarction, and repeat revascularization. The secondary outcome was MACE developed 0–6, 6–12, and 12–36 months after AMI. Results: The overall incidence of 36-month MACE was significantly higher as baseline hs-CRP increased (by groups: 8.8% vs. 8.6% vs. 10.7% vs. 15.4%, log-rank p < 0.001). The prognostic effect of baseline hs-CRP was mostly confined to the first 6 months after AMI (0–6 months MACE by groups: 1.6% vs. 2.3% vs. 4.3% vs. 6.1%, log-rank p < 0.001) and attenuated in high-intensity statin users. Six months after AMI, this prognostic effect of baseline hs-CRP was remarkably reduced (6–12 month MACE by groups: 2.4% vs. 2.1% vs. 2.8% vs. 4.0%, log-rank p = 0.111, 12–36 month MACE by groups: 4.7% vs. 4.1% vs. 4.0% vs. 6.2%, log-rank p = 0.218); however, high-intensity statin treatment showed a consistent improvement in outcome. The observed time-dependent prognostic effects remained consistent following multivariate analysis. Conclusions: The prognostic impact of elevated hs-CRP at baseline was most evident during the first 6 months after AMI; however, the use of high-intensity statin persistently improved the clinical outcome even after the resolution of inflammatory reactions.
AB - Background: Elevated high sensitivity C-reactive protein (hs-CRP) in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) has prognostic value for future cardiovascular events. This study aimed to ascertain a valid prognostic time-period for predicting cardiovascular outcome based on baseline hs-CRP in AMI patients undergoing successful PCI on statin therapy. Methods: Overall, 4410 AMI patients were enrolled from the Korea Acute Myocardial Infarction-National Institutes of Health (KAMIR-NIH) registry. Participants were divided into groups according to cut-off values of baseline hs-CRP (1.0, 3.0, and 10.0 mg/L) and statin therapy intensity. The primary outcome was 36-month major adverse cardiovascular events (MACE), a composite of all-cause mortality, any myocardial infarction, and repeat revascularization. The secondary outcome was MACE developed 0–6, 6–12, and 12–36 months after AMI. Results: The overall incidence of 36-month MACE was significantly higher as baseline hs-CRP increased (by groups: 8.8% vs. 8.6% vs. 10.7% vs. 15.4%, log-rank p < 0.001). The prognostic effect of baseline hs-CRP was mostly confined to the first 6 months after AMI (0–6 months MACE by groups: 1.6% vs. 2.3% vs. 4.3% vs. 6.1%, log-rank p < 0.001) and attenuated in high-intensity statin users. Six months after AMI, this prognostic effect of baseline hs-CRP was remarkably reduced (6–12 month MACE by groups: 2.4% vs. 2.1% vs. 2.8% vs. 4.0%, log-rank p = 0.111, 12–36 month MACE by groups: 4.7% vs. 4.1% vs. 4.0% vs. 6.2%, log-rank p = 0.218); however, high-intensity statin treatment showed a consistent improvement in outcome. The observed time-dependent prognostic effects remained consistent following multivariate analysis. Conclusions: The prognostic impact of elevated hs-CRP at baseline was most evident during the first 6 months after AMI; however, the use of high-intensity statin persistently improved the clinical outcome even after the resolution of inflammatory reactions.
KW - C-reactive protein
KW - Coronary artery disease
KW - Myocardial infarction
KW - Percutaneous coronary intervention
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85061141143&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061141143&partnerID=8YFLogxK
U2 - 10.1016/j.jjcc.2018.12.022
DO - 10.1016/j.jjcc.2018.12.022
M3 - Article
C2 - 30745001
AN - SCOPUS:85061141143
JO - Journal of Cardiology
JF - Journal of Cardiology
SN - 0914-5087
ER -