بررسی ارتباط بین سطح سرمی CRP با میزان مرگ و میر یک ماهه در بیماران مبتلا به سکته قلبی حاد در بیمارستان آریا در مدت یکسال

Subject Areas : علوم پزشکی

Mohammad  Sarafraz yazdi ¹ (متخصص داخلی، دانشکده پزشکی دانشگاه آزاد اسلامی مشهد، مشهد، ایران)
Mehrdad  Sadeghi Ordubadi ² ()
Ehsan  Roshandel ³ ()

Received: 2017-04-05 Accepted : 2017-04-05 Published : 2015-11-22

Keywords: Myocardial Infarction, C reactive protein,

Abstract :

Introduction: acute myocardial infarction (AMI) is one of the most common diseases, affecting the industrialized and developing worlds with an annual prevalence of 650,000 in the United States alone. Acute myocardial infarction has a 30% mortality rate, and noting the importance of its complications many methods have been introduced to estimate the severity and prognosis of the disease. One serologic method is determining CRP, whose serum levels reflect the severity and involvement of acute cardiac muscle involvement. Till now many studies have looked at CRP as a predictor of prognosis in patients suffering from acute myocardial infarction, yet the results proved unsatisfactory in predicting short term mortality (1 month). In this study we will measure serum levels of hsCRP and compare it with their prognosis. Aim: to assess the relation between CRP serum levels with 1 month mortality of patients suffering from AMI. Materials and Methods: in this cross-sectional study blood samples were drawn from patients with chest pain and a diagnosis of AMI, 24 hours after admission to the CCU. The samples were mixed with either heparin or EDTA and were quickly sent to the lab and kept at 2-8 degrees Celsius for a maximum of 8 days (if frozen samples can be stored for up to 3 months). In the lab samples’ CRP forms a complex with anti-CRP polyclonal antibodies on latex and will cause turbidity. The amount of turbidity indicates the CRP level present in the sample. The relationship is calculated via enforced immunoturbidity after analysis with a two point photometer. The kit used in this study had a sensitivity of 0.1 to 20 mg/dl (Pars Kit Azmoon). Based on the kit used, the normal level in adults was considered below 5mg/dl. The patients were fallowed up 30 days post AMI. Results: 85 AMI patients were included in this study from which 15 expired within the first month after the infarction. Mean hsCRP levels in the deceased was 8.89, and in the survivors 6.39 mg/dl (P=0.146). Also 60% of the decease revealed high hsCRP (>5mg/dl), while in the survivors 45% revealed high hsCRP. Conclusion: considering other risk factors in the population under study which can increase a patient’s mortality risk, it can be said that hsCRP’s can play a relative role in predicting of 1 month prognosis of AMI patients. Moreover, this valuable index must be used alongside other risk factors for a precise estimation of prognosis in AMI patients.    

References:

[1] Elliott M, Antman J, Braunwald E. ST Elevation MI in: Kasper DL, Braunnwald E, FauciAS, etal.  HARRISON'S the principles of internal medicine , 16^th Ed, NewYork: McGraw Hill; 2005, pp: 1448-1456.

 

[2]   Culabro P, Willerson J, Yeh E.T. Inflammatory cytokine stimulated C-reactive protein production by human caronary artery disease. Circulation J (108); 2003, pp: 1930-1932.

 

[3]  Elliott M,Braunwald E. chapter 46, ST Segmant elevation MI in: Zipes PD, Libby P, Bonow OR, Braun wald E. Braunwald's HEART DISEASE, A text Book of cardio vascular medicine; 7^th ed . Philadelphia: ELSEVIER; 2005, pp:1141-1166.

 

[4]  Kimura k. Relation ship bet ween myocardial damage and C-Reactve protein… jpn circulation j, 2001 Feb 65(2); Arailable form: www. Pub Med. gov [Abstrect].

 

[5] smith N.F, lesprance F, Irwin MR. Depression , C-reactive protein and 2yrs Major adverse cardiac Events in ACS, J Biopsych , 2006 (10), p:1016.

 

[6] Scott J Cameron , sokoll LJ, Laterza O.F. Amulti marker approach for the prediction of adverse events in Acs, Jcca, 2006, (vol:376), pp:168-173.