Open AccessComparison of C‐reactive Protein and Albumin Excretion as Prognostic Markers for 10‐Year Mortality After Myocardial Infarction
Author(s) -
Berton Giuseppe,
Cordiano Rocco,
Palmieri Rosa,
Cavuto Fiorella,
Buttazzi Patrizio,
Palatini Paolo
Publication year - 2010
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20792
Subject(s) - medicine , myocardial infarction , interquartile range , c reactive protein , creatinine , heart failure , cardiology , mortality rate , gastroenterology , inflammation
Abstract Background C‐reactive protein (CRP) is an established prognostic marker in the setting of acute coronary syndromes. Recently, albumin excretion rate also has been found to be associated with adverse outcomes in this clinical setting. Our aim was to compare the prognostic power of CRP and albumin excretion rate for long‐term mortality following acute myocardial infarction (AMI). Hypothesis To determine whether albumin excretion rate is a better predictor of long‐term outcome than CRP in post‐AMI patients. Methods We prospectively studied 220 unselected patients with definite AMI (median [interquartile] age 67 [60–74] y, female 26%, heart failure 39%). CRP and albumin‐to‐creatinine ratio (ACR) were measured on day 1, day 3, and day 7 after admission in 24‐hour urine samples. Follow‐up duration was 10 years for all patients. Results At survival analysis, both CRP and ACR were associated with increased risk of 10‐year all‐cause mortality, also after adjusting for age, hypertension, diabetes mellitus, prehospital time delay, creatine kinase‐MB isoenzyme peak, heart failure, and creatinine clearance. CRP and ACR were associated with nonsudden cardiovascular (non‐SCV) mortality but not with sudden death (SD) or noncardiovascular (non‐CV) death. CRP was not associated with long‐term mortality, while ACR was independently associated with outcome both in short‐ and long‐term analyses. At C‐statistic analysis, CRP did not improve the baseline prediction model for all‐cause mortality, while it did for short‐term non‐SCV mortality. ACR improved all‐cause and non‐SCV mortality prediction, both in the short and long term. Conclusions ACR was a better predictor of long‐term mortality after AMI than CRP. Copyright © 2010 Wiley Periodicals, Inc. This work was supported by grants from the University of Padova, Padova, Italy, for the collection, management, and analysis of the data. The authors have no other funding, finan‐ cial relationships, or conflicts of interest to disclose.