Effects of C-reactive Protein Level at Admission on Coronary Flow, Microcirculation and Left Ventricular Systolic Function in Patients with Acute STEMI Undergoing Primary Coronary Intervention

Increased C-reactive protein (CRP) blood levels are related to the inflammatory response, atherosclerosis and outcome after ST-elevation myocardial infarction (STEMI).

Aim: To test the hypothesis that CRP blood level is related to coronary artery flow, myocardial perfusion and left ventricular (LV) systolic function.

Methods: 123 patients presenting with acute anterior STEMI treated by primary percutaneous coronary intervention (PPCI) were examined. Clinical parameters, angiographic coronary flow and myocardial perfusion parameters, ST-elevation resolution, Doppler flow parameters in the left anterior descending coronary artery (LAD) and echocardiographic LV systolic function at admission and discharge were evaluated.

Results: Higher prevalence of peripheral vascular disease and higher KILLIP class was found in patients with higher CRP. A larger increase in CRP levels was related to worse myocardial blush. ST-Elevation resolution was not related to CRP levels. Shorter LAD diastolic deceleration time and lower LV ejection fraction at admission and discharge were found in those with higher maximal CRP levels, but they were not affected by admission CRP levels. CPK maximal levels, tended to be higher in those with higher maximal CRP.

Conclusions: Patients with higher maximal CRP levels had worse myocardial perfusion and LV systolic function, while admission CRP levels, in this context, were not significant in the modern PPCI era.