Prognosis after Acute Myocardial Infarction as Predicted by C-reactive Protein and Clinical Variables

10.5083/ejcm.20424884.88 , Cite or Link Using DOI
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Angelo Modica MD PhD, Fredrik Björklund MD PhD, Thomas Mooe MD PhD

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 clinical variables as well as interaction between variables have been incomplete. The aims of this study were to examine the predictive value of baseline concentrations of CRP for mortality after adjustment for important clinical variables and to compare the clinical usefulness of CRP with easily available clinical variables in the prediction of long term survival.

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.

In logistic regression analysis, the interaction term Age by Killip class > 1, the variable glomerular filtration rate as well as the interaction term Age by Atrial fibrillation were retained. The resulting model correctly predicted death or not in 81% of the patients. CRP did not contribute to the final model.

CRP does not independently predict long-term mortality after an AMI after adjustments for clinical variables and interaction. CRP has no value beyond clinical variables in predicting death after AMI.