Prediction of Infarct Transmurality From C-Reactive Protein Level and Mean Platelet Volume in Patients With ST-Elevation Myocardial Infarction: Comparison of the Predictive Values of Cardiac Enzymes

• Published in: Journal of clinical laboratory analysis Vol. 30; no. 6; pp. 930 - 940
• Main Authors: Kim, DongHun, Choi, Dong-Hyun, Kim, Bo-Bae, Choi, Seo-Won, Park, Keun Ho, Song, Heesang
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.11.2016; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Aged; Blood platelets; C-reactive protein; C-Reactive Protein - metabolism; Cohort Studies; Contrast Media; Creatine Kinase - metabolism; Electrocardiography; Female; Heart attacks; Humans; Kinases; Magnetic Resonance Imaging; Male; Mean Platelet Volume; Middle Aged; myocardial infarction; Myocardium - pathology; Percutaneous Coronary Intervention - methods; Predictive Value of Tests; Proteins; ROC Curve; ST Elevation Myocardial Infarction - blood; ST Elevation Myocardial Infarction - surgery; Statistics, Nonparametric; Troponin T; magnetic resonance imaging; C-reactive protein; myocardial infarction; mean platelet volume
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.21959

Background High C‐reactive protein (CRP) and mean platelet volume (MPV) levels are associated with poor prognosis in patients with ST‐segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the relationship between CRP level or MPV and infarct transmurality in patients with STEMI. Methods We retrospectively reviewed CRP level, MPV, and infarct transmurality in 112 STEMI patients who were assessed with contrast‐enhanced cardiac magnetic resonance imaging. Results When the cut‐off peak CRP level and MPV were set at 2.35 mg/dl and 7.3 fl using receiver operating characteristic curves analysis, the sensitivity was 67.3/69.2% and specificity was 76.7/76.7% for differentiating between the groups with and those without transmural involvement. Peak CRP level, MPV, peak creatine kinase‐MB (CK‐MB) level, and peak high‐sensitivity cardiac troponin T (hs‐cTnT) level had comparable predictive values for transmural involvement (area under the curve, 0.749, 0.761, 0.680, and 0.696, respectively). High peak CRP level and MPV were independent predictors of transmural involvement after adjusting for the peak CK‐MB level, peak hs‐cTnT level, baseline thrombolysis in myocardial infarction flow grade, and left ventricular ejection fraction (odds ratio: 5.16/5.42, 95% confidence interval: 1.84–14.50/2.03–14.47, P = 0.002/0.001, respectively) in the logistic regression analysis. Conclusion The results of this study show that peak CRP level and MPV are predictive markers for transmural involvement. Their predictive power for transmural involvement is independent of and comparable to that of peak CK‐MB and hs‐cTnT levels.