SERUM AMYLOID-A PROTEIN IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

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.