Predictive value of C-reactive protein best after acute phase of MI

NEW YORK (Reuters Health) – C-reactive protein (CRP) is a strong predictor of outcome among patients presenting with angina pectoris, but has no predictive value for patients during the acute phase of an MI. Based on this finding, members of the Intermountain Heart Collaborative Study Group recommend waiting until the acute phase of an MI has passed before measuring CRP for chronic cardiovascular risk assessment.

Dr. Jeffrey L. Anderson, of the University of Utah School of Medicine in Salt Lake City, and associates measured CRP for 599 patients with stable angina, 442 with unstable angina, and 319 with acute MI who presented for angiography. They report their findings in The American Journal of Cardiology for January 15.

In patients with stable angina, CRP above the first tertile was associated with a hazard ratio of 1.8 for death or nonfatal acute MI, after adjusting for traditional risk factors. For patients with unstable angina, a similarly elevated CRP yielded a hazard ratio of 2.7.

However, during hospitalization for acute MI, the level of CRP was independent of outcome.

Based on these findings, Dr. Anderson's group recommends that "CRP measurement should be delayed beyond the hospital phase of acute MI (at least 1 month)" for it to have prognostic value.

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