IN Hospital Outcome of Patients with Acute ST-Elevation Myocardial Infarction in Relation to Serum C-Reactive Protein levels at the Time of Hospital Admission

Abstract

Objectives: To determine the frequency of in-hospital outcomes among patients presenting with acute ST-segment elevation myocardial infarction (STEMI) having elevated C-reactive protein (CRP) level versus low CRP level at admission.

Methodology: An analytical cross-sectional study was carried out at the Department of Cardiology, Faisalabad Institute of Cardiology (FIC), Faisalabad during August 2022 to February 2023. A total of 230 patients between 25 to 65 years of age and of both genders admitted with acute STEMI within 24 hours of symptom onset were included. Venous blood samples were collected and forwarded to hospital pathology for CRP levels and routine clinical laboratory tests as per the guidelines. Patients were treated for acute STEMI according to hospital protocol. Left ventricular ejection fraction (LVEF) was measured using echocardiography by senior cardiologist using the biplane Simpson method before discharge in line with the ESC 2017 guidelines and the patients were categorized according to the CRP levels, LV systolic dysfunction (LVSD) and mortality.

Results: In this study, frequency of in-hospital outcomes of patients presenting with acute STEMI was found to be as follows; moderate to severe LVSD in 67 (29.1%) and in-hospital mortality in 18 (7.8%) patients. Among STEMI patients those with elevated CRP had significantly higher in-hospital mortality (17.1% vs 3%) and increased rates of moderate to severe LVSD (28.9% vs 8%).

Conclusion: Patients presenting with acute STEMI having elevated CRP levels had worse in-hospital outcomes, while those with low CRP levels experienced better outcomes.