Serum C-reactive protein elevation in left ventricular remodeling after acute myocardial infarction--role of neurohormones and cytokines.

Abstract

BACKGROUND:

We previously reported that increased peak serum C-reactive protein (CRP) level after acute myocardial infarction (AMI) was a major predictor of cardiac rupture and long-term outcome. The aim of this study was to clarify the role of serum CRP elevation as a possible marker of left ventricular (LV) remodeling after AMI.

METHODS:

We prospectively studied 31 patients who underwent primary angioplasty for a first anterior Q-wave AMI. Peak serum CRP level was determined by serial measurements after admission. LV volume and the plasma levels of various neurohormones and cytokines were measured on admission, and 2 weeks and 6 months after AMI.

RESULTS:

Patients with higher peak CRP levels (above the median) had a greater increase in LV end-diastolic volume during 2 weeks after AMI (+21+/-14 vs. +5+/-6 ml/m(2), P=0.001) and a lower ejection fraction (45+/-11 vs. 53+/-7%, P=0.02) than those with lower CRP levels, associated with a higher incidence of pump failure, atrial fibrillation, and LV aneurysm. Plasma levels of norepinephrine, brain natriuretic peptide, and interleukin-6 2 weeks after AMI were higher in the high CRP group than in the low CRP group.

CONCLUSIONS:

Increased peak serum CRP level was associated with a greater increase in LV volume after anterior AMI. Plasma norepinephrine and interleukin-6 levels were increased in patients with higher CRP levels, suggesting a possible role of sympathetic activation and enhanced immune response in the development of LV remodeling after AMI.

• Authors: Toshiyuki Takahashi, Toshihisa Anzai, Tsutomu Yoshikawa, Yuichiro Maekawa, Yasushi Asakura, Toru Satoh, Hideo Mitamura, Satoshi Ogawa
• Journal: International journal of cardiology (Int J Cardiol) Vol. 88 Issue 2-3 Pg. 257-65 (Apr 2003) ISSN: 0167-5273 [Print] Netherlands
• PMID: 12714206 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Cytokines
• Neurotransmitter Agents
• C-Reactive Protein

Topics

• Adult
• Aged
• Angioplasty, Balloon, Coronary
• C-Reactive Protein (analysis)
• Cytokines (blood, physiology)
• Electrocardiography
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (blood, physiopathology, therapy)
• Neurotransmitter Agents (blood, physiology)
• Predictive Value of Tests
• Prospective Studies
• Time Factors
• Ventricular Remodeling (physiology)