Cheng-Gang WANG, Xiu-Chuan QIN, Shao-Ping NIE, Chun-Mei WANG, Hui AI, Bin QUE. C-reactive protein as a predictor of malignant ventricular arrhythmias in non-ST elevation myocardial infarction[J]. Journal of Geriatric Cardiology, 2019, 16(8): 614-620. DOI: 10.11909/j.issn.1671-5411.2019.08.007
Citation: Cheng-Gang WANG, Xiu-Chuan QIN, Shao-Ping NIE, Chun-Mei WANG, Hui AI, Bin QUE. C-reactive protein as a predictor of malignant ventricular arrhythmias in non-ST elevation myocardial infarction[J]. Journal of Geriatric Cardiology, 2019, 16(8): 614-620. DOI: 10.11909/j.issn.1671-5411.2019.08.007

C-reactive protein as a predictor of malignant ventricular arrhythmias in non-ST elevation myocardial infarction

  • Objective To investigate whether C-reactive protein (CRP) is a biomarker of malignant ventricular arrhythmias (MVA) occurring in non-ST elevation myocardial infarction (NSTEMI) patients with Global Registry of Acute Coronary events (GRACE) scores Methods A total of 1450 NSTEMI patients were included in this study. Hs-CRP blood levels were measured via a turbidimetric immunoassay after confirming the diagnosis of NSTEMI with GRACE scores Results Consistent with prior studies, the MVA occurrence rate in our cohort was 6.7%, and patients with MVA exhibited a reduced left ventricular ejection fraction (46.1% ± 6.9% vs. 61.5% ± 8.7%, P = 0.032), a higher incidence of Killip classification > 1 (34.1% vs. 24.2%, P vs. 9.7%, P vs. 5.8%, P P = 0.003) in NSTEMI patients with MVA, and this increase appeared unrelated to other clinical parameters. The C-statistic to discriminate MVA was 0.82 (95% CI: 0.74–0.89). Using receiver operating characteristics analysis, we optimized a cutoff point of 16 mL/L, and the sensitivity and specificity were 95% and 61%, respectively; the positive predictive value was 20% and the negative predictive value was 99%. Conclusions An hs-CRP assay is a potential MVA biomarker in low-risk NSTEMI patients with GRACE scores < 140. If validated in prospective studies, hs-CRP may offer a low-cost supplementary strategy for risk stratification for NSTEMI patients.
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