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Background: Elevated C-reactive protein (CRP) was shown to be associated with an increased risk for new-onset atrial fibrillation (AF) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI); however, the optimal time frame to measure CRP for risk stratification is not known., Objectives: To evaluate the relation between the change in CRP over time (CRP velocity [CRPv]) and new-onset AF among STEMI patients treated with primary PCI., Methods: We included 801 STEMI patients who underwent PCI between 2007 and 2017 and had their CRP measured with a wide range assay (wr-CRP) at least twice during the 24 hours after admission. CRPv was defined as the change in wr-CRP concentration (mg/l) divided by the change in time (in hours) between the two measurements. Patient medical records were reviewed for occurrence of new-onset AF., Results: New onset AF occurred in 45 patients (6%). Patients with new onset AF had significantly higher median CRPv (1.27 vs. 0.43 mg/l/h, P = 0.002). New-onset AF during hospitalization occurred in 3.4%, 4.5 %, and 9.1% of patients in the first, second and third CRPv tertiles, respectively (P for trend = 0.006). In a multivariable logistic regression, adjusting for clinical variables the odds ratios for new onset AF was 1.93 (95% confidence interval 1.0-3.59, P = 0.04) for patients in the third CRPv tertile., Conclusions: CRPv might be an independent and rapidly measurable biomarker for new-onset AF following primary PCI in STEMI patients.

Background: Elevated C-reactive protein (CRP) was shown to be associated with an increased risk for acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI), however, the optimal time frame to measure CRP for risk stratification is not known. We evaluated the relation between the change in CRP over time (CRP velocity-CRPv) and AKI among STEMI patients treated with primary PCI., Methods: We included 801 STEMI who presented between 2007 and 2017 and had their CRP measured with a wide range assay (wr-CRP) at least twice during the 24 h after admission. CRPv was defined as the change in wr-CRP concentration (mg/l) divided by the change in time (in h) between the two measurements. Patient's medical records were reviewed for occurrence of AKI., Results: Mean age was 62 ± 16 and 80% were males. Patients with AKI had significantly higher CRPv (1.47 versus 0.4 mg/l/h, p < 0.001). In a multivariate regression model CRPv was independently associated with AKI (OR 1.03, 95% CI 1.01-1.0 5, p = 0.001). On receiver operating characteristic (ROC) curve the optimal cutoff value of CRPv to predict AKI was measured as more than 0.8 mg/l/h, with 70% sensitivity and 65% specificity (AUC 0.712, 95% CI 0.64-0.78, p < 0.001)., Conclusion: CRPv might be an independent and rapidly measurable biomarker for AKI following primary PCI in STEMI patients.

Background: Elevated periprocedural high sensitive C-reactive protein (hs-CRP) was shown to be associated with an increased risk for acute kidney injury (AKI) in non-myocardial infarction (MI) patients undergoing percutaneous coronary intervention (PCI), however, no information to date is present regarding its predicting role for AKI in MI patients. We evaluated whether admission serum hs-CRP levels may predict risk of AKI among ST elevation MI (STEMI) patients undergoing primary PCI., Methods: Five hundred and sixty-two patients that were admitted with STEMI and treated with primary PCI were included in the study. Serum hs-CRP levels were determined from blood samples taken prior to PCI. Patients' medical records were reviewed for occurrence of AKI, in-hospital complications and 30 days mortality., Results: Mean age was 62 ± 16 and 455 (80 %) were males. Patients were divided into two groups, according to their admission hs-CRP values: group 1: hs-CRP ≤9 mg/l (n = 394) and group 2: hs-CRP >9 mg/l (n = 168). Patients with hs-CRP >9 mg/l had significantly higher rate of AKI following PCI (17 vs. 6 %; p < 0.001), more in-hospital complications and higher30 -day mortality rate (11 vs. 1 %; p = 0.02). In a multivariable logistic regression model admission hs-CRP level >9 mg/l was an independent predictor for AKI (OR 2.7, 95 % CI: 1.39-5.29; p = 0.001) and a strong trend for 30 day mortality (OR 4.27, 95 % CI: 0.875-21.10; p = 0.07)., Conclusion: Admission serum hs-CRP level >9 mg/l is an independent predictor for AKI following primary PCI in STEMI patients.

Background: An elevated C-reactive protein (CRP) level is associated with adverse outcomes in patients with acute myocardial infarction (AMI). Although CRP levels have been shown to be associated with left ventricular (LV) systolic function and remodeling in AMI, little is known about their relation to early LV diastolic function., Methods: We retrospectively studied 173 consecutive patients <75 years of age with first ST-segment elevation MI (STEMI) that was treated by primary percutaneous coronary intervention (PPCI). They had presented within 24h of chest pain onset and their CRP levels were determined within 6h of hospital admission. They all underwent echocardiography within 3 days of admission and were stratified by CRP tertiles., Results: The cut-off points for the CRP tertiles were <2.6 mg/L, 2.6-7.9 mg/L, and >7.9 mg/L. Patients with higher CRP levels had a significantly higher mean mitral inflow E wave velocity (68 ± 16 cm/s vs 77 ± 19 cm/s vs 76 ± 17 cm/s; p=0.02), a higher E/average e' (8.9 ± 1.9 vs 9.8 ± 2.8 vs 10.4±3.2; p=0.02), and a higher systolic pulmonary artery pressure (27 ± 6 mmHg vs 30 ± 8 mmHg vs 32 ± 10 mmHg; p=0.04). Elevated CRP levels were associated with more advanced diastolic dysfunction than normal CRP levels (p=0.04). The admission CRP level was an independent predictor of average E/e' ratio (multivariate analysis)., Conclusion: Admission CRP levels are associated with echocardiographic parameters of elevated LV filling pressure in patients with STEMI treated with PPCI., (Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Objective: The recently introduced Bayerwide-range C-reactive protein (wr-CRP) assay might be relevant for the real-time low-cost and online determination of inflammatory bowel disease (IBD) activity. Our aim was to examine whether wr-CRP can substitute for the Dade Behring high sensitivity C-reactive protein (hs-CRP) assay in IBD patients., Methods: A total of 71 patients with IBD, of whom 48 had Crohn's disease CD and 23 had ulcerative colitis (UC) with various intensities of disease activity participated in the study. The CRP of patients who were under treatment at the Department of Gastroenterology and Liver Diseases were measured using both wr-CRP and the hs-CRP., Results: A significant (r = 0.995; P < 0.001) correlation was noted between the hs-CRP and wr-CRP measurements for the whole sample as well as for the two diseases, CD (r = 0.994; P < 0.001) and UC (r = 0.997; P < 0.001), which were analyzed separately., Conclusion: The Bayer wr-CRP assay might be a useful low-cost and real-time inflammation-sensitive biomarker in patients with IBD.

High-sensitivity C-reactive protein (hs-CRP) is a biomarker that correlates with atherothrombotic risk and outcome. hs-CRP is influenced by various modifiable and non-modifiable factors. We studied the relationship between ethnic background and hs-CRP level, among the Jewish population in Israel. A total of 3659 men and 2180 women were divided into two ethnic groups (Ashkenazi and Sephardic Jews), based on the knowledge of Jewish immigration patterns throughout the centuries. Mean hs-CRP levels were calculated for each group and were adjusted for various factors known to influence hs-CRP. Sephardic Jews were found to have higher adjusted mean hs-CRP levels (2.0 mg l(-1) for men and 3.9 mg l(-1) for women) compared with Ashkenazi Jews (1.5 mg l(-1) for men and 2.9 mg l(-1) for women). Ethnic background emerged as an independent significant predictor of hs-CRP levels. We demonstrated that ethnicity is an important factor when considering hs-CRP as a marker of atherothrombotic risk.

Background: C-reactive protein (CRP) has been tested in patients with systolic heart failure (HF) and mixed results have been obtained with regards to its potential predictive value. However, the role of C-reactive protein (CRP) in patients with diastolic HF is not established. We studied the predictive role of high sensitivity CRP (hsCRP) in patients with diastolic HF., Methods: HsCRP levels were measured in a cohort of CHF outpatients, 77 patients with diastolic HF and 217 patients with systolic HF. Concentrations were compared to a large cohort of healthy population (n=7701) and associated with the HF admissions and mortality of the patients., Results: Levels of hsCRP did not differ between patients with systolic and diastolic HF and were significantly elevated compared to the cohort of healthy subjects even after adjustment to various clinical parameters (p<0.0001). In patients with diastolic HF, hsCRP levels associated with New York Heart Association functional class (NYHA-FC) (r=0.31 p=0.01). On univariate Cox regression model hsCRP levels independently predicted hospitalizations in patients with systolic but not diastolic HF (p=0.047)., Conclusion: HsCRP concentrations are elevated in patients with diastolic HF and correlate with disease severity; their prognostic value in this patient population should be further investigated.

The erythrocyte sedimentation rate (ESR) can be used to identify low-grade inflammation that contributes to future vascular events. ESR determinants, however, have not been explored in the absence of a subclinical or microinflammatory response. The ESR was determined in a large cohort of apparently healthy participants, excluding subjects with high-sensitivity C-reactive protein (hs-CRP) concentrations more than 5 mg/L (47.62 nmol/L). Linear regression models were used to identify the determinants of the ESR. The study population comprised 6,237 subjects. The main laboratory variables found to affect ESR were levels of fibrinogen, hemoglobin, globulin, and triglycerides (all P < .001; R2 = 0.34 and 0.44 for men and women, respectively). Sex was found to affect ESR alone and in combined interactions with most other variables. Age did not affect ESR. The main determinants of ESR in an inflammation-free cohort are sex and levels of fibrinogen, hemoglobin, globulins, and triglycerides.

This study compared the recently introduced cheaper and more accessible wide-range C-reactive protein (wr-CRP) with the commonly used high-sensitivity C-reactive protein (hs-CRP) in patients undergoing coronary angiography. One hundred fifty-two consecutive patients who were admitted to a tertiary medical center and underwent angiography were included in the study. Arterial blood was obtained for the 2 assays at the beginning of angiography. A highly significant correlation (r = 0.983, p <0.001) was found between the 2 methods. This correlation was observed in different clinical scenarios and in different ranges of CRP. In conclusion, the real-time, online, and low-cost wr-CRP assay is a reasonable alternative to the Behring Dade hs-CRP method in the setting of stable and unstable coronary artery disease.

Background/aims: As opposed to regular C-reactive protein (CRP) assays, the introduction of high-sensitivity ones has enabled us to detect low grade inflammation in patients with inflammatory bowel disease (IBD). We addressed the subject of the degree of correlation between the concentration of high-sensitivity CRP (hs-CRP) and the inflammatory IBD activity score., Methods: Included were 90 patients with Crohn's disease (CD), 70 with ulcerative colitis (UC) and 160 controls. Disease activity was determined using CD activity index (CDAI) for CD and Mayo score for UC. The Dade Boering BNII Nephelometer was used to determine the hs-CRP concentrations., Results: The coefficient of correlation between hs-CRP and the disease activity score was similar for both UC (0.26) and CD (0.36)., Conclusions: These findings are relevant for therapeutic intervention in which a greater absolute reduction in the hs-CRP concentration in CD patients (who generally present higher CRP concentrations than those found in UC) might be interpreted as a better response compared to the same absolute reduction in UC patients. This information is needed for clinicians using the hs-CRP assay to estimate IBD disease activity in daily practice., (Copyright (c) 2006 S. Karger AG, Basel.)

OBJECTIVE: The positive correlation between the time from symptom onset to the appearance of an inflammatory response and erythrocyte aggregation (EA) in the peripheral blood of acute coronary syndromes (ACS) patients had been previously reported by us. We now analyze the added prognostic value of EA in ACS patients undergoing percutaneous coronary interventions (PCI). METHODS: We performed an analysis on prospectively collected data at a tertiary hospital catheterization laboratory between 2006-2011. Cox regression models were fitted for EA cut-offs and performed separately for myocardial infarction (MI) and unstable angina pectoris (UAP) patients. Major adverse cardiovascular events (MACE) were defined as all-cause mortality, MI and stroke. Follow up time was defined as the time from PCI to either MACE or November 20, 2011. RESULTS: Included were 1055 patients (637 with MI and 418 with UAP). The median follow up in the MI and the UAP groups was 14 and 15 months, respectively (maximal follow up of 4.1 years). In the UAP group there was a significant increase in the MACE for the group with high EA (HR = 2.3, p = 0.04) compared to the group of patients with low EA. This was not found for patients presenting with MI. CONCLUSIONS: Elevated EA portends worse outcomes in UAP patients undergoing PCI. [ABSTRACT FROM AUTHOR]

It is not clear whether acute stress of a few hours duration is capable of increasing the concentration of C-reactive protein (CRP), a valuable biomarker in patients with acute myocardial infarction or stroke. Therefore, we measured the concentration of CRP in patients who presented with an acute fracture and in whom we can assume that the CRP concentrations prior to the event were within the normal limits. There were 20 patients with bone fractures and 20 gender- and body mass index (BMI)-matched controls aged 52 ± 27 and 51 ± 21 years, respectively [mean ± standard deviation (SD)]. The patients were examined 3.2 ± 2.5 h (mean ± SD) after their actual trauma and presented with modestly elevated concentrations of CRP (2.7 ± 2.1 mg/L) as compared with the controls (2 ± 2.2 mg/L). At the same time, the expected increment in the white blood cell count was noted in the patients (12.4 ± 3 × 103/mL) as opposed to the controls (7.1 ± 1.9, p < 0.001). We conclude that the expected increment in CRP within a few hours after the onset of acute traumatic stress is modest. The findings are relevant for stressful conditions of acute myocardial infarction and stroke that present within a few hours after the onset of pain and in which elevated CRP levels might represent the causative inflammation and are not necessarily a result of the acute stress/infarction per se. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]