C-Reactive protein on admission and the success of thrombolytic therapy with streptokinase: is there any relation?

被引:6
作者
Amasyali, B [1 ]
Kose, S
Kilic, A
Iyisoy, A
Barcin, C
Kursaklioglu, H
Barindik, N
Tokgoz, S
Isik, E
Demirtas, E
机构
[1] Gulhane Mil Med Acad, Dept Cardiol, TR-06018 Ankara, Turkey
[2] Gulhane Mil Med Acad, Dept Biochem, TR-06018 Ankara, Turkey
关键词
D O I
10.1016/S0167-5273(03)00054-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Recent evidence has demonstrated that inflammation plays a major role in the initiation and progression of atheroma plaques. C-reactive protein (CRP) is shown to have prognostic significance in acute coronary syndromes. We investigated the influence of CRP levels before thrombolytic therapy on infarct-related artery (IRA) patency and the degree of residual stenosis. Methods: 45 consecutive patients with a first attack of acute myocardial infarction (MI) who underwent streptokinase therapy and subsequently coronary angiography were enrolled into the study. Patients were divided into 2 groups according to the level of CRP on admission. Results: Serum CRP levels were greater than or equal to 0. 5 mg/dL in 26 patients (Group-I) and < 0.5 mg/dL in 19 patients (Group-II). The patency of IRA (TIMI-2 and 3) evaluated at 90th minute after the initiation of thrombolytic therapy was similar between the two groups (62% vs. 68%, p > 0.05). However, the presence of TIMI-3 flow was significantly lower and TIMI-2 flow was higher in Group-I as compared to Group-II (12% vs. 53%, p = 0.003 and 50% vs. 16%, p = 0.018 respectively). Additionally, among patients with patent IRA, the degree of residual stenosis was significantly higher in Group-I (80 +/- 14% vs. 68 +/- 15%, p = 0.032). Conclusion: High serum CRP levels on admission in patients within 6 hours after the start of acute ST-segment elevation MI are associated with lower TIMI flow grades and higher residual stenosis of IRA after intravenous streptokinase. Our observations imply that patients with higher CRP levels on admission require closer follow-up during and after acute MI. (C) 2003 Elsevier Ireland Ltd. All fights reserved.
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页码:27 / 33
页数:7
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