Level Variation And Clinical Significance Of C-reactive Protein, Troponin T In Patients With Acute Myocardial Infarction Pre-and Post The Coronary Intervention

Objective:Percutaneous coronary intervention (percutaneous coronary intervention, PCI) has become an efficient means for the treatment of coronary heart disease. With the evolution of operator experience and equipment design ,procedural mortality is occasional.But procedural coronary vascular and myocardial injury is still the common complication .High-sensitivity C-reactive protein (High-sensitivity C-reactive protein,hsCRP) is a typical acute phase proteins ,which can be increased within 24 h after tissue injury.The cardiac troponin T (cardiac troponin T, cTnT) is the sensitive serological markers developed in recent years,which reflects of myocardial necrosis .This study,we survey the change of hsCRP, cTNT levels in patients with acute ST segment elevation myocardial infarction (ST-segment elevation myocardial infarction, STEMI) pre- and post PCI treatment. To explore the possible significance of hsCRP, cTNT to deliver the prognosis in patients with STEMI.Methods:To select 62 SAP patients and 130 STEMI patients diagnosed according to WHO revised diagnostic criteria。To detect levels of hsCRP,cTNT on admission ;to detect level variation of hs-CRP,cTnT of STEMI patients on 24,36,48,72 h after incidence and 2 weeks after surgery. Among STEMI patients 83 patients who were accepted percutaneous coronary intervention divided to PCI group and 47 patients who were accepted conservative treatment with medication divided to Drug treatment group.To compare the level dynamic change of hs-CRP, cTnT between two group. According to cTnT and hs-CRP detect results 24 hours after, PCI group divided once again : A group(cTnT<0.4ng/mL和hs-CRP<3mg/L);B group(cTnT≥0.4ng/mL或hs-CRP≥3mg/L);C group(cTnT≥0.4ng/mL和hs-CRP≥3mg/L);and follow-up the incidence of MACE and the specific occurrence of all patients within 12 months.Results:The results show:①Patients with STEMI on admission serum hs-CRP and cTNT positive rate was significantly higher than patients with SAP (p <0.05).②Serum levels of hsCRP and cTNT change over time pre-and post PCI.Compare with Drug treatment group, the serum hsCRP levels of PCI group forward peak time, and the peak level is increased.While cTNT concentration of PCI group is significantly reduced,the difference was statistically significant (p <0.05).③Among PCI group,the incidences of total MACE significantly increased in B group and C group than that in A group (all P<0.01).The incidences of total MACE in C group is higher than that in B group (P<0.05).④Observed through the follow-up,The incidences of non-fatal myocardial infarction,cardiac death and total MACE significantly increased in hs-CRP and cTNT elevated patients than that in hs-CRP and cTNT normal group(P<0.05).Conclusion:After emergency PCI, the STEMI patients monitor the levels variation of hsCRP and cTNT together can prompt the success of reperfusion therapy. The levels of cTNT and hsCRP can predict the early prognosis of patients with STEMI on the early stages,and for high-risk patients to take more aggressive treatment program can make greater gains.