Relationship between myocardial damage and C-reactive protein levels immediately after onset of acute myocardial infarction

The present study investigated the relationship between myocardial damage a nd C-reactive protein (CRP) levels, with no increase in creatine kinase (CK ) activity, immediately after the onset of acute myocardial infarction (AMI ) in 85 patients with their first reperfused anterior AMI without CK elevat ion on admission and no ischemic events during hospitalization. Patients we re classified into those with low levels (<0.3 mg/dl) of CRP (Group L; n=67 ) and those with high Levels (<greater than or equal to>0.3mg/dl) of CRP (G roup H; n=18). Group H had a higher proportion of patients with a history o f preinfarction angina (89 vs 55%, p<0.01), especially unstable angina. CST in leads V1-6 on admission ECG was lower in Group H than in Group L (14+/- 7 vs 21+/-13 mm, p<0.05). Predischarge left ventriculography showed that th e left ventricular global ejection fraction (55+/-11 vs 48+/-10%, p<0.01) a nd SD/chord at the left anterior descending artery lesion (-1.7+/-0.9 vs -2 .3+/-0.9, p<0.01) were better in Group H. Multivariate analysis demonstrate d that both CRP on admission (p=0.011) and preinfarction angina (p=0.002) w ere independently associated with better regional wall motion (SD/chord >-2 .0) before discharge. These results suggest that the clinical situation of elevated CRP immediately after onset is associated with less myocardial dam age and better left ventricular function in reperfused anterior AMI.