• Yong Un Kang, Min Jee Kim, Joon Seok Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Young-Keun Ahn, Myung Ho Jeong, Young Jo Kim, Myeong Chan Cho, Chong Jin Kim, Soo Wan Kim, and Other Korea Acute Myocardial Infarction Registry Investigators.
• Department of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Gwangju 501-757, Korea. skimw@chonnam.ac.kr.
• Yonsei Med. J. 2014 Jan 1; 55 (1): 132-40.

PurposeThe present study aimed to investigate the impact of high-sensitivity C-reactive protein (hs-CRP) and renal dysfunction on clinical outcomes in acute myocardial infarction (AMI) patients.Materials And MethodsThe study involved a retrospective cohort of 8332 patients admitted with AMI. The participants were divided into 4 groups according to the levels of estimated glomerular filtration rate (eGFR) and hs-CRP: group I, no renal dysfunction (eGFR ≥60 mL·min(-1)·1.73 m(-2)) with low hs-CRP (≤2.0 mg/dL); group II, no renal dysfunction with high hs-CRP; group III, renal dysfunction with low hs-CRP; and group IV, renal dysfunction with high hs-CRP. We compared major adverse cardiac events (MACE) over a 1-year follow-up period.ResultsThe 4 groups demonstrated a graded association with increased MACE rates (group I, 8.8%; group II, 13.8%; group III, 18.6%; group IV, 30.1%; p<0.001). In a Cox proportional hazards model, mortality at 12 months increased in groups II, III, and IV compared with group I [hazard ratio (HR) 2.038, 95% confidence interval (CI) 1.450-2.863, p<0.001; HR 3.003, 95% CI 2.269-3.974, p<0.001; HR 5.087, 95% CI 3.755-6.891, p<0.001].ConclusionHigh hs-CRP, especially in association with renal dysfunction, is related to the occurrence of composite MACE, and indicates poor prognosis in AMI patients.

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