Correlation between the Serum Levels of Uric Acid and HS-CRP with the Occurrence of Early Systolic Failure of Left Ventricle Following Acute Myocardial Infarction
Abstract
Recent studies show that, Inflammation plays an important role in the initiation and progression of atherosclerosis and in the pathogenesis of acute cardiovascular events. There is a possible association between ventricular dysfunction following acute myocardial infarction and high Sensitivity C-reactive protein (HS-CRP) and uric acid. In this study we assessed the relationship between HS-CRP and uric acid with LVEF and Killip Class in patients with acute myocardial infarction (AMI). In a cross sectional study, 188 patients (63 females and 125 males) with AMI (STEMI) who were admitted in CCU ward in Emam Khomeini Hospital, Tehran/Iran, were entered. Uric acid and HS-CRP were measured within first day of admission. We measured ejection fraction (LVEF) and used Killip classification system. The mean age of patients was 60.4±9.2 years. The mean of uric acid was 5.9±1.6, 6.6±2.1, 7.1±2.1 and 9.4±1.3 in patients with Killip Class I, II, III and IV, respectively (P=0.005). The mean of HS-CRP was 1.9±1.4, 14.2±10.9, 12.2±10.9 and 15.7±6.7 in patients with Killip Class I, II, III and IV, respectively (P=0.005). There was a relationship between HS-CRP and LVEF (Correlation coefficient= -0.788, P<0.001), but there was not between uric acid and LVEF (Correlation coefficient= -0.111, P=0.129), The plasma concentration of C-reactive protein correlated with LVEF and Killip Class in patients with AMI but serum uric acid was just correlated with Killip Class IV. It seems that plasma concentrations of HS-CRP and uric acid are useful for prediction of development of heart failure in AMI patients. More future studies are necessary for final judgment.
Taghavi M. State of Death in 18 states of Iran in 2001, Tehran, Iran.
Mahmudi MJ, Saghafi H, Fakhrzadeh H, Heshmat R, Shafaie A, Larijani B. Prevalance disorder of lipidemia in family of patients with early coronary disease. J Iran Diabetes and Lipid 2006;5(3):271-79.
World Health Organization (WHO). Cardiovascular disease: Prevention and Control. [online] 2009 May 12 [cited 2011 July 15]; Available from: URL:http://www.who.int/dietphysicalactivity/publications/facts/cvd/en
Ridker PM, Libby P. Preventive cardiology: Risk factors for atherothrombotic disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, editors. Braunwald's Heart Disease: Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2007. p. 1013.
Marrow DA. C-Reactive protein in cardiovascular disease. UpToDate online 19.2. [online] 2009 July 14 [cited 2011 May]; Available from: URL:http://www.uptodate.com/contents/c-reactiveprotein- in-cardiovascular-disease
Kushner I. The phenomenon of the acute phase response. Ann N Y Acad Sci 1982;389:39-48.
Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO 3rd, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC Jr, Taubert K, Tracy RP, Vinicor F; Centers for Disease Control and Prevention; American Heart Association. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107(3):499-511.
Zacho J, Tybjaerg-Hansen A, Jensen JS, Grande P, Sillesen H, Nordestgaard BG. Genetically elevated Creactive protein and ischemic vascular disease. N Engl J Med 2008;359(18):1897-908.
Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV, Dhillon B, Weisel RD, Li RK, Mickle DA, Stewart DJ. A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 2002;106(8):913-9.
Pasceri V, Cheng JS, Willerson JT, Yeh ET. Modulation of C-reactive protein-mediated monocyte chemoattractantprotein-1 induction in human endothelial cells by antiatherosclerosis drugs. Circulation 2001;103(21):2531-4.
Smit JJ, Ottervanger JP, Slingerland RJ, Kolkman JJ, Suryapranata H, Hoorntje JC, Dambrink JH, Gosselink AT, de Boer MJ, Zijlstra F, van 't Hof AW; On-TIME= Study Group. Comparison of usefulness of C-reactive protein versus white blood cell count to predict outcome after primary percutaneous coronary intervention for ST elevation myocardial infarction. Am J Cardiol 2008;101(4):446-51.
Dedobbeleer C, Melot C, Renard M. C-reactive protein increase in acute myocardial infarction. Acta Cardiol 2004;59(3):291-6.
Pinelli M, Bindi M, Filardo FP, Moroni F, Castiglioni M. Serum uric acid levels correlate with left ventricular ejection fraction and systolic pulmonary artery pressure in patients with heart failure. Recenti Prog Med 2007;98(12):619-23.
Cengel A, Türkoğlu S, Turfan M, Boyaci B. Serum uric acid levels as a predictor of in-hospital death in patients hospitalized for decompensated heart failure. Acta Cardiol 2005;60(5):489-92.
Krishnan E. Hyperuricemia and incident heart failure. Circ Heart Fail 2009;2(6):556-62.
Brodov Y, Chouraqui P, Goldenberg I, Boyko V, Mandelzweig L, Behar S. Serum uric acid for risk stratification of patients with coronary artery disease. Cardiology 2009;114(4):300-5.
Tatli E, Aktoz M, Buyuklu M, Altun A. The relationship between coronary artery disease and uric acid levels in young patients with acute myocardial infarction. Cardiol J 2008;15(1):21-5.
Lazzeri C, Valente S, Chiostri M, Sori A, Bernardo P, Gensini GF. Uric acid in the acute phase of ST elevation myocardial infarction submitted to primary PCI: its prognostic role and relation with inflammatory markers: a single center experience. Int J Cardiol 2010;138(2):206-9.
Nadkar MY, Jain VI. Serum uric acid in acute myocardial infarction. J Assoc Physicians India 2008;56:759-62.
Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, Lakka TA, Salonen JT. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 2004;164(14):1546-51.
Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 1999;131(1):7-13.
Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997;336(14):973-9. Erratum in: N Engl J Med 1997;337(5):356.
| Files | ||
| Issue | Vol 49, No 8 (2011) | |
| Section | Original Article(s) | |
| Keywords | ||
| Myocardial infarction Uric acid C-reactive protein Ventricular dysfunction | ||
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