C-Reactive protein levels on admission are associated with response to thrombolysis and prognosis after ST-segment elevation acute myocardial infarction

Background Several studies have shown the independent association of high plasma C-reactive protein (CRP) levels with an adverse prognosis in patients with acute myocardial infarction. However, the possible association of plasma CRP levels with response to thrombolysis and short- and long-term cardiac mortality has not been investigated. The aim of this study was to evaluate these possible associations. Methods Three hundred nineteen consecutive patients who received intravenous thrombolysis because of ST-segment elevation acute myocardial infarction were prospectively studied. Patients were classified according to tertiles of plasma CRP levels on admission. Results Patients at the top tertile had a significantly lower incidence of complete ST-segment resolution (third vs first, P < .001, third vs second, P = .009) or Thrombolysis In Myocardial Infarction (TIMI) 3 flow in the infraction-related artery (third vs first, P < .001, third vs second, P = .02), more compromised left ventricular function (third vs first, P = .02, second vs third, P = .04), greater inhospital mortality (third vs first, P = .03, third vs second, P = .06), and greater 3-year cardiac mortality (third vs first, P = .01, third vs second, P = .07). Conclusions Plasma levels of CRP on admission may be a predictor of reperfusion failure and of short- and longterm prognosis in patients with ST-segment elevation acute myocardial infarction.