Prognosis after acute myocardial infarction as predicted by CRP and clinical variables
(English)Manuscript (preprint) (Other academic)
Objective. Raised concentrations of C-reactive protein (CRP) have been reported to be strongly related to an adverse long term prognosis in patients with acute myocardial infarction (AMI). However, adjustments for possible confounders have often been incomplete. Thus the clinical usefulness of CRP to predict long term survival in absolute figures has not been clarified. The aims of this study were to examine the predictive value of baseline concentrations of CRP for mortality after adjustment for the most important clinical variables and to compare the clinical usefulness of CRP with easily available clinical variables in the prediction of long term survival.
Design. Five hundred and thirty-one patients with AMI were included. A blood sample for CRP was obtained on admission. All patients were followed for a minimum of two years and death of any cause was recorded as the study end point.
Results. In logistic regression analysis the interaction term age by Killip class > 1 and the variables glomerular filtration rate, intervention and atrial fibrillation were retained. The resulting model correctly predicted death or not in 82% of the patients. CRP did not contribute to the final model.
Conclusions. An elevated C-reactive protein concentration is reported to be associated with death in patients with AMI, but the association is absent after adjustment for an important interaction among the variables in the model. CRP has no value beyond clinical variables in predicting death after AMI.
C-reactive protein, Myocardial infarction, Prognosis, Death
Cardiac and Cardiovascular Systems
Research subject Medicine
IdentifiersURN: urn:nbn:se:umu:diva-32518OAI: oai:DiVA.org:umu-32518DiVA: diva2:303931