C-reactive protein, infarct size, microvascular obstruction, and left-ventricular remodelling following acute myocardial infarction.

Abstract:

AIMS:This study assessed the relationship between inflammatory mediators and indices of infarct size and left-ventricular (LV) remodelling following successful primary percutaneous coronary intervention (PCI) in patients with first time ST elevation myocardial infarction (MI). METHODS AND RESULTS:Forty-two patients admitted with an occluded single vessel were recruited consecutively. Cardiac magnetic resonance was used for serial assessment (2 days, 1 week, 2 months) of infarct size, microvascular obstruction (MO), and LV remodelling. Inflammatory mediators were analysed before and after PCI. Our major findings were: (1) Following PCI, there was a marked increase in plasma levels of C-reactive protein, closely correlated with an increase in interleukin-6 and terminal complement complex, reaching maximum 2 days after PCI; (2) C-reactive protein 2 days after PCI was significantly correlated with infarct size and parameters of LV remodelling 2 months after PCI; (3) Patients with persistent MO had significantly higher C-reactive protein levels 2 days following PCI. CONCLUSION:We suggest that the rapid increase in C-reactive protein levels in this model of successful revascularization of a single, totally occluded vessel reflects the degree of inflammation within the infarcted area. Our findings support a role for C-reactive protein-mediated complement activation as both a marker and mediator of myocardial damage following MI. Clinical study no.: NCT 00465868.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Ørn S,Manhenke C,Ueland T,Damås JK,Mollnes TE,Edvardsen T,Aukrust P,Dickstein K

doi

10.1093/eurheartj/ehp070

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

1180-6

issue

10

eissn

0195-668X

issn

1522-9645

pii

ehp070

journal_volume

30

pub_type

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