Naslov
Value of anemia, C-reactive protein and fibrinogen to predict thirty-day mortality in patients with acute ST-segment elevation myocardial infarction treated with primary angioplasty

Autori
Vrsalović, Mislav ; Getaldić, Biserka ; Vrkić, Nada ; Pintarić, Hrvoje

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Heart Journal Supplements / Ferrari, Roberto - Oxford : European Society of Cardiology (ESC), 2010, F14-F15

Skup
4th Official Congress of the Working Group on Acute Cardiac Care

Mjesto i datum
Kopenhagen, Danska, 16.10.2010. - 19.10.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
myocardial infarction; ST-segment elevation; C-reactive protein; fibrinogen; anemia

Sažetak
Purpose: Anemia, C-reactive protein and fibrinogen are independent predictors of adverse outcome in patients with acute myocardial infarction. The purpose of the study was to examine them together in the clinical setting. Methods: The study included 543 patients (pts) with first ST-segment elevation myocardial infarction (STEMI), admitted to the University hospital from January 2001 to December 2007. In all the pts angioplasty of the culprit lesion was performed (pts with <12 h after the onset of symptoms were included and pts with alignant or inflammatory disease were excluded). Whole group characteristics: 62% man, mean age 65 years, diabetes in 27%, hypertension in 64%, current smoking in 35%, hyperlipidemia in 34%, infarct related artery: left anterior descending artery in 43%, left circumflex artery in 14%, right coronary artery in 43%, Killip class >1 in 14%, multivessel disease in 54%, TIMI flow: >1 pre PCI in 22%, >1 post PCI in 96%. Hematocrit (Hct), C- reactive protein (CRP) and fibrinogen (FIB) were obtained at the time of admission. The primary end point was all-cause mortality within 30 days after admission. Results: 41 pts (7.5%) died during the 30-day follow-up. Nonsurvivors (NS) were older, more frequently females and were more likely to have diabetes (p<0.01). Less smokers and pts with dyslipidemia were in NS group (p<0.01). Congestive heart failure, anterior location of the myocardial infarction and multivessel disease were more prevalent in NS group, as well as worse baseline and final TIMI flow (p<0.01), while time to treatment was comparable in both groups. CRP (24.7 mg/L vs 12.6 mg/L, p<0.001) and FIB (4.99 g/L vs 4.44 g/L, p = 0.001) were higher, while Hct (38.8% vs 41%, p<0.001) was lower in NS. Both CRP and FIB negatively correlated with Hct (r = −0.17 and r = −0.22, p<0.001) and positively with each other (r = 0.43, p<0.001). In the univariable analyses anemia (Hct <39% for men and <36% for women), elevated CRP (>6.7 mg/L) and FIB (>3.9 g/L) (cutoff points of CRP and FIB were calculated with ROC analysis) were significantly associated with the primary outcome (p<0.01). After multivariable adjustment for gender, age, cardiovascular risk factors, Killip class >1, TIMI flow, multivessel disease, anterior infarction and the remaining two of the examined laboratory parameters, the odds ratios in prediction of 30-day mortality were: 12.23 (p = 0.01), 8.12 (p = 0.04) and 2.19 (p = 0.33), for anemia, elevated CRP and FIB respectively. Conclusion: Anemia and CRP, but not FIB, are independently related to short term mortality in pts with STEMI treated with primary percutaneous coronary intervention.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Farmacija

POVEZANOST RADA