SPC365

Plasma kinesis and prognostic impact of CRP in STEMI patients

Session: Posters - O. Basic Science
Speaker: Pedro Custodio

Congress: CPC 2021
Topic: O. Basic Science
Theme: 36. Basic Science
Subtheme: 36.2 Basic Science - Cardiac Biology and Physiology
Session Type: Posters
FP Number: ---
Authors: Pedro Custódio; David Roque; Inês Fialho; Luis Brízida; Carlos Morais
<p style="text-align:justify"><span style="font-size:12pt"><strong><span style="font-size:9.0pt">Introduction:</span></strong></span></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Patients with ST segment elevation myocardial infarction(STEMI) frequently show a rise in core temperature along with inflammatory markers in the days following the acute event. Contrary to myocardial troponins, which are present In the intracellular apparatus, C-reactive protein(CRP) is a penthraxin synthesized in response to inflammation or infection with an important extracellular component. Knowledge about CRP biological kinesis in STEMI patients and its prognostic significance might avoid inappropriate wasting of medical resources &ndash; namely increase in hospital and coronary intensive care unit (CICU) days, along with futile antimicrobial prescription.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Objective:</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Evaluate the plasma kinesis and prognostic impact of CRP in STEMI patients.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Methods:</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">&nbsp;Retrospective single center analysis of 98 consecutively included STEMI patients admitted to the CICU between January and June 2018. Patients with chronic inflammatory diseases,&nbsp; cancer, inward stay &lt; 48 hours, Killip Kimball class IV at admission and those that didn&rsquo;t have daily CRP and Troponin T HS assessment for the first 72 in-hospital&nbsp; hours were excluded, n=29. </span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">&nbsp;Demographic and clinical data was evaluated.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">CRP and Troponina T Hs plasma levels were assessed, as were the prescription of antibiotics without positive cultures or clear evidence of infection.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">In-Hospital mortality was assessed. An independent sample T test was used to assess CRP value differences between groups based on in-hospital mortality.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Outcomes:</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">A total of 69 patients were included, mean age 64,8(+/- 13,2years). Antibiotics were administered in 9 patients(12,7%). As for the prevalence of cardiovascular risk factors: Obesity (IMC&gt;30) 17,3%; <em>diabetes mellitus</em> 33.3%, tobacco smoking 46,4%, Dyslipidemia 49,2%; Hypertension 60,8%. AF was present in 13%.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">The peak troponin T HS levels were reached 24 hours after the acute event, while the peak CRP plasma concentration was reached in the 5<sup>th</sup> inward day &ndash; Figure 1. </span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">CRP levels show a positive relation to in-hospital mortality for the first 48 hours ( Day 1: F = 12,391; p=.001/ Day 2 F=5.955 p=.017), having non-statiscally significant impact in the following measuments, up to the 6<sup>th</sup> day- Figure 2.</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Conclusion:</span></span></strong></p>

<p style="text-align:justify"><strong><span style="font-size:12pt"><span style="font-size:9.0pt">Frist and second day CRP values have a statistically significant relation to in-hospital mortality in STEMI patients. The average peak CRP plasma concentration in this population was seen in the 5<sup>th</sup> day, which may correspond to the normal inflammatory response.</span></span></strong></p>