Backgrounds: This study aimed to know how high sensitivity C-reactive protein (hs-CRP) effects on early outcomes after acute ST elevation MI (STEMI), especially, in the patient underwent PCI. Methods: As part of KORMI study, this study enrolled 3028 STEMI patients (mean age: 63 ± 13, male: n=2258, 74.6%) underwent PCI, from January 2008 to June 2009. Patients were stratified into 4 groups as follow; Group I: hs-CRP level was less than 0.3mg/l (n=958, 31.7%), Group II: from 0.3mg/l to 3.0mg/l (n=1243, 41.0%), Group III: from 3.0mg/l to 15.0 mg/l (n=561, 18.5%), Group IV: 15.0 mg/l or more (n=266, 8.8%). Major adverse cardiovascular events (MACE) including death, recurrent MI, and revascularization rate were analyzed and compared among each groups. Mean follow up duration was 224 ± 121 days. Results: There were significant differences in baseline characteristics, laboratory findings and angiographic findings including age, sex, prior stroke, lipid profile, and coronary lesion characteristics. In-hospital mortality rate of Group IV was highest and was about 2-fold of Group III (10.8% vs. 5.6%, p<0.001). Those of Group I and II were 1.9% and 3.0%, respectively. On multivariate logistic regression analysis, the increased mortality risk was observed only in the highest hs-CRP Group [odd ratio16.40 (95% confidence interval 1.85 to 87.45, p=0.012) as compared with group I. At 6th month on follow up, there was stepwise increase of the MACE rate according to hs-CRP group (4.6%, 6.5%, 8.6%, and 12.4% from group I to Group IV, respectively, p<0.001) (Figure 1). After adjusting for other factors, however, Cox-proportional hazard analysis revealed that there was no significant prognostic role in our study population. Conclusion: In our study, the prognostic role of hs-CRP was found only in the mortality during hospitalization and seemed to be limited to the highest quartile.
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