Abstract:
OBJECTIVES:This study was designed to prospectively determine, in patients with an acute coronary syndrome, whether the inflammatory marker, C-reactive protein (CRP), measured at hospital admission, discharge, and 1 month later has incremental value to predict outcomes at 1 year. BACKGROUND:The clinical utility of CRP measurements in patients with acute coronary syndromes remains uncertain. Limitations of previous studies have been retrospective design and incomplete adjustment for readily available clinical prognosticators. METHODS:The CRP marker was measured at admission, hospital discharge, and 1 month later in consecutive patients hospitalized for acute coronary syndromes in 8 tertiary and secondary hospitals. The primary outcome was a composite of death, nonfatal myocardial infarction (MI), and unstable angina (UA) with electrocardiogram (ECG) changes at 1 year. RESULTS:A total of 1,210 patients, age 62 +/- 12 years, 64% with acute myocardial infarction (MI) and 36% with unstable angina (UA), were recruited. At 1 year, the primary outcome occurred in 142 patients (11.7%) and included 58 deaths (4.8%), 79 nonfatal MIs (6.5%), and 26 UA episodes with ECG changes (2.1%). The unadjusted odds ratios (ORs) (95% confidence intervals) of CRP values at admission, hospital discharge, and 1 month later for the occurrence of the primary outcome were 1.20 (1.06 to 1.36), 0.98 (0.85 to 1.14), and 1.23 (1.00 to 1.50), respectively. After multivariate adjustment, ORs were 1.04 (0.91 to 1.20), 0.90 (0.77 to 1.06), and 1.12 (0.93 to 1.34), respectively. The individual components of the primary outcome were also not independently associated with any of the 3 CRP measurements. CONCLUSIONS:The modest predictive ability of CRP following admission for an acute coronary syndrome disappeared after adjusting for common clinical variables. This large prospective study does not support the incremental value of measuring CRP in this clinical setting.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Bogaty P,Boyer L,Simard S,Dauwe F,Dupuis R,Verret B,Huynh T,Bertrand F,Dagenais GR,Brophy JMdoi
10.1016/j.jacc.2008.03.019subject
Has Abstractpub_date
2008-06-17 00:00:00pages
2339-46issue
24eissn
0735-1097issn
1558-3597pii
S0735-1097(08)01127-3journal_volume
51pub_type
杂志文章,多中心研究abstract::Two patients with complete heart block complicating extensive anterior myocardial infarction underwent late (greater than 40 hours) coronary reperfusion with angioplasty. One to one atrioventricular conduction was restored within minutes of reperfusion despite a lack of measurable ventricular muscle salvage as demonst...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(85)80061-9
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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doi:10.1016/s0735-1097(96)00351-8
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2003.10.073
更新日期:2004-06-16 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.03.036
更新日期:2007-07-24 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1996-10-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-05-17 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(97)00433-6
更新日期:1998-01-01 00:00:00
abstract::Kawasaki disease (KD) is an acute, self-limited vasculitis that typically occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric age group in ...
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pub_type: 杂志文章,评审
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更新日期:2009-11-17 00:00:00