Korean Circ J.  2012 Mar;42(3):164-172. 10.4070/kcj.2012.42.3.164.

Prognostic Impact of Baseline High-Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Based on Body Mass Index

• Ahmed K
• Jeong MH
• Chakraborty R
• Cho KH
• Sim DS
• Hong YJ
• Ahn Y
• Hachinohe
• Cho MC
• Kim CJ
• Kim YJ

• KMID: 2225030
• DOI: http://doi.org/10.4070/kcj.2012.42.3.164

Abstract

BACKGROUND AND OBJECTIVES
Serum high sensitivity C-reactive protein (hs-CRP) is a marker of inflammation and may lead to the development of atherosclerosis, adversely affecting mortality. The aim of this study was to evaluate the relationship between baseline hs-CRP level and 12-month clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) according to their body mass index (BMI) status.
SUBJECTS AND METHODS
Using data from the Korea Acute Myocardial Infarction Registry from November 2005 to September 2008, a total of 8174 consecutive AMI patients were studied. Cox proportional hazard model revealed that higher baseline levels of hs-CRP was associated with 12-month all-cause mortality (p=0.045). To further understand this association, patients were divided into 3 groups based on their body mass index: 1) overweight/obese, 2) normal weight, and 3) underweight patients. Then each group was stratified into quartiles based on their hs-CRP.
RESULTS
In overweight/obese patients, Cox model showed significant association of hs-CRP with 12-month mortality when adjusted for age and gender (p<0.001), however, after adjustment with multiple covariates, mortality was highest in the 4th quartile {HR 2.382, (1.079-5.259), p=0.032} though statistically insignificant (p=0.172). We observed no significant association of serum hs-CRP with 12-month mortality in normal weight (p=0.681) and underweight (p=0.760) patients.
CONCLUSION
Higher baseline hs-CRP level (> or =4.08 mg/dL) in overweight/obese AMI patients showed significant association with 12-month all-cause mortality independent of other prognostic markers.

Keyword

C-reactive protein; Overweight; Obesity; Body mass index; Myocardial infarction

MeSH Terms

Atherosclerosis
Body Mass Index
C-Reactive Protein
Humans
Inflammation
Korea
Myocardial Infarction
Obesity
Overweight
Percutaneous Coronary Intervention
Proportional Hazards Models
Thinness
C-Reactive Protein

Figure

• 

  Fig. 1 Adjusted Cox proportional hazard survival curves for 12-month all-cause mortality and high sensitivity C-reactive protein (hs-CRP) quartiles in AMI patients undergoing PCI in (A) total study population, overall p=0.045, between 1st and 2nd quartile p=0.093, between 1st and 3rd quartile p=0.015 and between 1st and 4th quartile p=0.007; (B) overweight/obese group, overall p=0.172, between 1st and 2nd quartile p=0.213, between 1st and 3rd quartile p=0.150 and between 1st and 4th quartile p=0.032; (C) normal-weight group, overall p=0.681, between 1st and 2nd quartile p=0.824, between 1st and 3rd quartile p=0.337 and between 1st and 4th quartile p=0.623; and (D) underweight group, overall p=0.760, between 1st and 2nd quartile p=0.293, between 1st and 3rd quartile p=0.469 and between 1st and 4th quartile p=0.658. AMI: acute myocardial infarction, PCI: percutaneous coronary intervention.

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