The concentrations of four acute phase proteins were measured in sera
of 40 patients with acute myocardial infarction (AMI) to evaluate thei
r behaviour from day-to-day and to find out if they can serve for earl
y prediction of postinfarction complications and mortality rate. Peak
levels of serum amyloid A protein (SAA) were increased up to 5000-fold
above the normal value and those of C-reactive protein (CRP) about 10
0-fold, 3 days after AMI. alpha 1-antichymotrypsin (ACT) and alpha 1-a
cid glycoprotein (AGP) peak levels were increased up to eightfold abov
e their normal values. Patients who developed postinfarction complicat
ions had significantly higher SAA values on admission than those witho
ut complications (mean values of 379 and 45 mg/L, respectively; P < 0.
0001). Using a level of 100 mg/L on admission as a reference value gav
e a reasonable sensitivity and predictive value for complications (73%
) and a very good sensitivity (80%) for early prediction of fatal outc
ome. Patients with SAA values above this limit had double the risk of
complications and four times the risk of a fatal outcome. The correlat
ion with CRP values was lower than it was with SAA values (P = 0.028)
using a level of 15 mg/L on admission as reference value gave low sens
itivity (55%) and predictive value (60%) for complications as well as
low sensitivity for early prediction of fatal outcome (60%). The prese
nt study did not allow prediction of complications or mortality based
on ACT or AGP values.