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2019, vol. 76, iss. 10, pp. 979-984
Prognostic significance of inflammatory biomarkers in diabetic and non-diabetic patients with STEMI, treated with primary percutaneous coronary intervention
aMilitary Medical Academy, Clinic for Emergency Internal Medicine, Belgrade
bMilitary Medical Academy, Clinic for Emergency Internal Medicine, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade
Background/Aim. Although the prognostic significance of inflammatory biomarkers, C-reactive protein (CRP) and fibrinogen, in the patients with the ST-segment elevation myocardial infarction (STEMI) is already known, the specific difference between such patients according to diabetic status remains unknown. Methods. The study was conducted in a single tertiary center. The values of CRP and fibrinogen were measured during the first 48 h in consecutive patients with first STEMI treated with primary percutaneous coronary intervention (pPCI). The patients were divided into two groups: with diabetes and without diabetes. The aim of this study was to determine a prognostic significance of maximal values of these two inflammatory biomarkers for in-hospital and six-month mortality in these two groups. Results. Among 475 patients, 126 (26.5%) were with diabetes and 349 (73.5%) were without diabetes. The patients with diabetes had significantly higher median values of CRP and fibrinogen compared to the nondiabetic patients [29.6 (10.4-91.8) mg/L vs 22.4 (9.79-49.2) mg/L, p = 0.046 and 4.7 (3.6-6.3) g/L vs 4.3 (3.6-5.4) g/L, p = 0.026, respectively]. However, the multivariate survival analysis using the Cox regression model showed that in the nondiabetic STEMI patients CRP and fibrinogen had significant prognostic value for in-hospital mortality [hazard ratio (HR) = 1.013, 95% confidence interval (CI) (1.004-1.022), p = 0.004; HR = 1.529 (1.023-2.287), p = 0.039, respectively]. Regarding six-month mortality, no significant difference was achieved. Overall survival was the lowest in the fourth quartile of CRP in the patients without diabetes. Conclusion. The higher values of CRP are the significant independent predictor of in-hospital and overall mortality in the STEMI patients without diabetes treated with primary PCI. Fibrinogen can also be used as an additional prognostic inflammatory biomarker for in-hospital mortality in the non-diabetics with STEMI.
Chan, D., Ng, L.L. (2010) Biomarkers in acute myocardial infarction. BMC Medicine, 8(1), 34-34
Coppola, G., Rizzo, M., Abrignani, M.G., Corrado, E., di Girolamo, A., Braschi, A., et al. (2005) Fibrinogen as a predictor of mortality after acute myocardial infarction: A forty-two-month follow-up study. Ital Heart J, 6(4), 315-322
Cristal, N., Slonim, A., Bar-Ilan, I., Hart, A. (1983) Plasma fibrinogen levels and the clinical course of acute myocardial infarction. Angiology, 34(11), 693-698
di Stefano, R., di Bello, V., Barsotti, M.C., Grigoratos, C.C., Armani, C., Dell'omodarme, M., Carpi, A., Balbarini, A. (2009) Inflammatory markers and cardiac function in acute coronary syndrome: Difference in ST-segment elevation myocardial infarction (STEMI) and in non-STEMI models. Biomedicine & Pharmacotherapy, 63(10), 773-780
Fang, L., Moore, X.L., Dart, A.M., Wang, L.M. (2015) Systemic inflammatory response following acute myocardial infarction. J Geriatr Cardiol, 12(3), 305-312
Khera, A., McGuire, D.K., Murphy, S.A., Stanek, H.G., Das, S.R., Vongpatanasin, W., Wians, F.H., Grundy, S.M., de Lemos, J.A. (2005) Race and gender differences in C-reactive protein levels. Journal of the American College of Cardiology, 46(3), 464-469
Kim, K.H., Kim, W.H., Kang, W.Y., Hwang, S.H., Cho, S.C., Kim, W.H., Jeong, M.H. (2013) The impact of ischemic time on the predictive value of high-sensitivity C-reactive protein in ST-segment elevation myocardial infarction patients treated by primary percutaneous coronary intervention. Korean Circulation Journal, 43(10), 664-673
Lakoski, S.G., Cushman, M., Palmas, W., Blumenthal, R., D'agostino, R.B., Herrington, D.M. (2005) The relationship between blood pressure and C-reactive protein in the multi-ethnic study of atherosclerosis (MESA). Journal of the American College of Cardiology, 46(10), 1869-1874
Liuzzo, G., Buffon, A., Biasucci, L.M., Gallimore, R.J., Caligiuri, G., Vitelli, A., Altamura, S., Ciliberto, G., Rebuzzi, A.G., Crea, F., Pepys, M.B., Maseri, A. (1998) Enhanced inflammatory response to coronary angioplasty in patients with severe unstable angina. Circulation, 98(22), 2370-2376
Lontchi-Yimagou, E., Sobngwi, E., Matsha, T.E., Kengne, A.P. (2013) Diabetes mellitus and inflammation. Current Diabetes Reports, 13(3), 435-444
Monnier, L., Mas, E., Ginet, C., Michel, F., Villon, L., Cristol, J., Colette, C. (2006) Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA, 295(14), 1681-1687
Nikfardjam, M., Mullner, M., Schreiber, W., Oschatz, E., Exner, M., Domanovits, H., Laggner, A.N., Huber, K. (2000) The association between C-reactive protein on admission and mortality in patients with acute myocardial infarction. Journal of Internal Medicine, 247(3), 341-345
o'Loughlin Jennifer,, Lambert, M., Karp, I., McGrath, J., Gray-Donald, K., Barnett, T.A., Delvin, E., Levy, E., Paradis, G. (2008) Association between cigarette smoking and C-reactive protein in a representative, population-based sample of adolescents. Nicotine & Tobacco Research, 10(3), 525-532
Ortolani, P., Marzocchi, A., Marrozzini, C., Palmerini, T., Saia, F., Taglieri, N., Baldazzi, F., Silenzi, S., Bacchi-Reggiani, M.L., Guastaroba, P., Grilli, R., Branzi, A. (2008) Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention. European Heart Journal, 29(10), 1241-1249
Ribeiro, D.R.P., Ramos, A.M., Vieira, P.L., Menti, E., Bordin, J.O.L., Souza, P.A.L.D., Quadros, A.S.D., Portal, V.L. (2014) High-sensitivity c-reactive protein as a predictor of cardiovascular events after ST-elevation myocardial infarction. Arquivos Brasileiros de Cardiologia, 103(1), 69-75
Saleh, N., Svane, B., Jensen, J., Hansson, L.O., Nordin, M., Tornvall, P. (2005) Stent implantation, but not pathogen burden, is associated with plasma C-reactive protein and interleukin-6 levels after percutaneous coronary intervention in patients with stable angina pectoris. American Heart Journal, 149(5), 876-882
Sheikh, A.S., Yahya, S., Sheikh, N.S., Sheikh, A.A. (2012) C-reactive protein as a predictor of adverse outcome in patients with acute coronary syndrome. Heart Views, 13(1), 7-12
Steg, P.G., James, S.K., Atar, D., Badano, L.P., Blömstrom-Lundqvist, C., Borger, M.A. (2012) Task Force on the management of STsegment elevation acute myocardial infarction of the European Society of Cardiology (ESC): ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J, 33(20), 2569-2619
Suleiman, M., Aronson, D., Reisner, S.A., Kapeliovich, M.R., Markiewicz, W., Levy, Y., Hammerman, H. (2003) Admission C-reactive protein levels and 30-day mortality in patients with acute myocardial infarction. American Journal of Medicine, 115(9), 695-701
Suleiman, M., Khatib, R., Agmon, Y., Mahamid, R., Boulos, M., Kapeliovich, M., Levy, Y., Beyar, R., Markiewicz, W., Hammerman, H., Aronson, D. (2006) Early inflammation and risk of long-term development of heart failure and mortality in survivors of acute myocardial infarction. Journal of the American College of Cardiology, 47(5), 962-968
Zairis, M.N., Adamopoulou, E.N., Manousakis, S.J., Lyras, A.G., Bibis, G.P., Ampartzidou, O.S., Apostolatos, C.S., Anastassiadis, F.A., Hatzisavvas, J.J., Argyrakis, S.K., Foussas, S.G. (2007) The impact of hs C-reactive protein and other inflammatory biomarkers on long-term cardiovascular mortality in patients with acute coronary syndromes. Atherosclerosis, 194(2), 397-402
Ziakas, A., Gavrilidis, S., Giannoglou, G., Souliou, E., Gemitzis, K., Kalampalika, D., Arvanitidou, V.M., Pidonia, I., Parharidis, G., Louridas, G. (2006) In-hospital and long-term prognostic value of fibrinogen, CRP, and IL-6 levels in patients with acute myocardial infarction treated with thrombolysis. Angiology, 57(3), 283-293


article language: English
document type: Original Scientific Paper
DOI: 10.2298/VSP170905175M
published in SCIndeks: 09/11/2019
peer review method: double-blind
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