The Effect Of High-Sensitivity C-Reactive Protein On Outcomes In Patients With Acute Myocardial Infarction After Emergency PCI

Background:Emergency PCI has become the preferred way to treat patients with acute myocardial infarction.High-sensitivity c-reactive protein is precently recognized as an inflammatory marker.It plays an indispensable role in inflammation process,such as plaque occurring, developing and its complications( plaque ruptures,thrombosis, acute coronary syndrome),by combining with its receptor[1].It is an independent predictor of cardiovascular events.This article discuss the relationship between hs-CRP and severity of coronary lesions, the heart function and the incidence of major adverse cardiovascular events(MACE) during the period of hospitalization through to 585 patients with acute myocardial infarction for the first time who accept the emergency PCI.Objective:This study discuss the relationship between the high-sensitivity C-reactive protein level and outcomes in patients with acute myocardial infarction(AMI) for the first time after emergency percutaneous coronary intervention(PCI),by measuring the concentration of serum hs-CRP, recording the counts of narrow coronary observed in the coronary angiography(CAG),evaluating the heart function and the incidence of major adverse cardiovascular events during hospitalization.Method:(1)From January 1,2013 to May 31,2015,585 patients with acute myocardial infarction for the first time who stayed and accepted emergency PCI in Cardiovascular internal medicine,The first hospital affiliated to suzhou university were chosen.(2)With3mg/L as the boundary of high-sensitivity c-reactive protein concentration, patients were divided into the high hs-CRP group and low hs-CRP group.(3)Detailed information of the general clinical data(gender, age, previous medical history, wheather thrombolysis outside the hospital prior to admission ect.)was collected.At the same time, results observed in the emergency PCI(counts of coronary stenosis,crime vascular, and narrow area) and intraoperative situation(with or without using suction catheter, Intra-aortic balloon pump(IABP), presence of ventricular fibrillation) were recorded. Postoperative ECG monitoringwas carried out on the patients.One day after admission, blood routine examination,biochemistry analysis,type B amino terminal natriuretic peptide(NT-proBNP),troponin were measured and recorded.Recorded the results of heart Doppler examination,such as left ventricular ejection fraction(LVEF),assessed the Killip classification of the patients.Treatment information were collected as well as in-hospital combined cardiac events such as all-cause mortality,malignant arrhythmia, acute heart failure, cardiac shock.(4) The general clinical data,the lesion vessel counts,the heart function and the incidence of major adverse cardiovascular events(MACE) during hospitalization were retrospective compared and analyzed between the two groups of patients, and the difference have statistical significance. And to explore the related factors affecting the incidence of MACE and the contribution degree of hs-CRP.Results:(1)Patients with acute myocardial infarction in high hs-CRP group had more stenosed coronary vessels than patients in low hs-CRP group,and there was statistical difference between them.(P <0.05).(2)The hs-CRP level in patients with acute myocardial infarction was negatively correlated with left ventricular ejection fraction(P <0.01), and positively correlated with the NT-proBNP level(P <0.01), high hs-CRP group has a bigger proportion of patients who were Killip Ⅳ than the other group(P <0.05).(3)The higher the hs-CRP level was,the higher incidence of adverse cardiovascular events was, including sinus arrest, cardiac shock, heart attack, hospital death rate(P <0.05).(4)The age(OR =1.049), the hs-CRP(OR =1.055), the WBC count(OR =1.173),smoking(OR =2.176) are the independent predictors of incidence of MACE during hospitalization in patients with acute myocardial infarction.Conclusion:1. The higher the hs-CRP level was,the more serious the degree of pathological changes were,the worse the heart function was,the higher the incidence of major adverse cardiovascular events(MACE) during hospitalization were. 2.Inflammation in patients with AMI is an important predictor of prognosis of them.