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. 2007 Oct;194(2):397-402.
doi: 10.1016/j.atherosclerosis.2006.08.008. Epub 2006 Sep 8.

The impact of hs C-reactive protein and other inflammatory biomarkers on long-term cardiovascular mortality in patients with acute coronary syndromes

Michael N Zairis  1 , Evdokia N Adamopoulou, Stavros J Manousakis, Anastassios G Lyras, George P Bibis, Olga S Ampartzidou, Charalambos S Apostolatos, Filippos A Anastassiadis, John J Hatzisavvas, Spyros K Argyrakis, Stefanos G Foussas; Biomarkers of Inflammation and Outcome in Acute Coronary Syndromes (BIAS) Investigators
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The impact of hs C-reactive protein and other inflammatory biomarkers on long-term cardiovascular mortality in patients with acute coronary syndromes

Michael N Zairis et al. Atherosclerosis. 2007 Oct.

Abstract

We evaluated whether high circulating levels of serum amyloid A (SAA), fibrinogen, interleukin-6 (IL-6) or leukocytes count (LC), can provide any additional predictive value over that provided by hs C-reactive protein (hs-CRP) for the incidence of 5-year cardiovascular mortality, in 458 and 476 consecutive patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndromes (NSTE-ACS), respectively. By 5 years the incidence of cardiovascular mortality was 37.3% and 35.5% in patients with STEMI and NSTE-ACS, respectively. Each of the study inflammatory biomarkers conferred independent to clinical risk predictors (and to cardiac troponin I) long-term prognostic information (all p<0.05), but only LC provided additional predictive value over that provided by hs-CRP, in either cohort (p<0.05). By multivariate Cox regression analysis, hs-CRP (p<0.001 for both cohorts) and LC (p=0.009 and p<0.001 for STEMI and NSTE-ACS, respectively) were the only inflammatory biomarkers independently associated with the incidence of 5-year cardiovascular mortality. According to the present results high circulating levels of LC but not of SAA, fibrinogen or IL-6 can provide additional long-term predictive value over that provided by hs-CRP in patients with acute coronary syndromes.

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