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Pol. Merkur. Lek (Pol. Med. J.), 2011, XXXI/181: 009-014 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2011, XXXI/181: 009-014

Title: Evaluation of clinical usefulness of selected laboratory markers in the prediction of myocardial infarction in patients under secondary prevention

Authors: Plak M., Łobos M., Religa W., Tokarek A., Bonar A., Janas B., Paradowski M.

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Evaluation of clinical usefulness of selected laboratory markers in the prediction of myocardial infarction in patients under secondary prevention


Plak M.1, Łobos M.2, Religa W.3, Tokarek A.1, Bonar A.1, Janas B.4, Paradowski M.2

1Hospital of the Ministry of Internal Affairs and Administration in Łódź, Poland, Department of Laboratory Diagnostics; 2Military Teaching Hospital, Veterans Central Hospital in Łódź, Poland, Department of Laboratory Diagnostics and Clinical Biochemistry; Hospital of the Ministry of Internal Affairs and Administration in Łódź, Poland: 3Department of Interventional Cardiology; 4Occupational Medicine Clinic

The aim of the study was to evaluate the range of chronic inflammation in patients after second or subsequent myocardial infarction, and to compare it with its range in patients after first MI.
Material and methods
. C-reactive protein measurement clinical value was examined by high sensitivity CRP method (hsCRP) and compared to clinical value of other heart attack risk factors: total cholesterol (TC) and cholesterol in HDL fraction (HDL-C), triglycerides (TG) and fibrinogen (FBG). The research included 120 patients in two investigated groups: Z2 – 30 patients undergoing secondary prevention after second (subsequent) heart attack, and Z1 – 30 patients with first myocardial infarction. There were two reference groups: KOR – 30 people undergoing planned coronarography and K – 30 healthy individuals. Groups Z2, Z1 and KOR patients were treated with PCI (percutaneous coronary intervention).
Results
. HsCRP medians for group Z2 (2.65 mg/l) and groups Z1 (2.25 mg/l) and KOR (2.35 mg/l) were significantly higher than in group K (1.10 mg/dl).
Conclusions
. Highest clinical value of hsCRP in coronary attack prediction was confirmed. Relative area under ROC curve (AUC) was highest in group Z2, higher than in group Z1 (0.778 and 0.711, respectively). In patients undergoing secondary prevention, group Z2, hsCRP measurement showed higher clinical value in subsequent myocardial infarction prediction than in first one. In groups Z2 and Z1, HDL-C measurement also shows high diagnostic value for coronary risk assessment. AUC are 0.875 and 0.782, respectively. However, in treatment with statins, high AUC values do not necessarily reflect myocardial infarction risk.

Key words: myocardial infarction prediction, secondary prevention, CRP, lipid

Pol. Merk. Lek., 2011, XXXI, 181, 9