Predictive value of basal C-reactive protein levels for myocardial salvage in patients with acute myocardial infarction is dependent on the type of reperfusion treatment

Aims To evaluate whether C-reactive protein (CRP) levels on admission are predictive of myocardial salvage achieved with different reperfusion strategies in patients with acute myocardial infarction (AMI). Methods and results Patients with AMI treated with stenting plus abciximab (n=125) and thrombolysis alone (n=54) or with abciximab (n=71) were prospectively studied. CRP levels were measured by a high sensitivity assay. The threshold of the upper quartile (12 mg/l) was used to divide patients into two groups: 60 patients with high CRP (>12 mg/l) and 190 patients with tow CRP (less than or equal to12 mg/l). Myocardial salvage was measured by technetium (Tc)-99(m) sestamibi scintigraphy. Patients in the high CRP group had a significantly tower salvage index (0.35+/-0.42 vs 0.48+/-0.34, p=0.01) and higher 18-month mortality (11.7 vs; 3.2%, p=0.03) compared to those in the tow CRP group. White basal CRP was not related to myocardial salvage in patients treated with stenting plus abciximab (p=0.89) or thrombolysis plus abciximab (p=0.43), a high CRP on admission was associated with a significantly lower salvage index (0.09+/-0.48 vs 0.42+/-0.37 in the tow CRP group, p=0.006) among patients treated with thrombolysis alone. Conclusion CRP levels on admission may predict the efficacy of reperfusion in patients with AMI. The predictive ability is dependent on the form of reperfusion therapy. (C) 2003 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.