Abstract
The serum levels of C-reactive protein on admission may predict the efficacy of reperfusion in patients with acute myocardial infarction.
Objectives: This study was conducted to know the predictive value of CRP for success of thrombolysis and to know the prognostic value of C-reactive protein in patients having acute myocardial infarction.
Study Design: It was single center, open labeled cross sectional study.
Materials and Methods: Sixty patients of acute myocardial infarction diagnosed on clinical and ECG criteria, who received thrombolytic therapy with streptokinase, were included in the study. The diagnosis of acute myocardial infarction was made on clinical parameters and ECG criteria. The ECG changes were noted before starting thrombolysis. The baseline sample for C-reactive protein (CRP1) was taken before starting thrombolysis. The time duration between onset of symptoms and start of thrombolysis was also noted. The thrombolysis was done with streptokinase infusion, 1.5 million units diluted in 100ml normal saline, intravenously over one hour. The ECG was repeated after six hours of completion of thrombolysis and, changes were noted and compared with ECG changes before thrombolysis. Now second sample for C-reactive protein (CRP2) was taken after six hours of completion of thrombolysis. CRP was measured by a high sensitivity assay which can accurately measure basal levels of CRP throughout the currently accepted cardiovascular risk assessment range (0.20 - 10.0 mg/L). According to ECG findings after thrombolysis, all patients were divided into two groups. Group A was considered as successful group to thrombolysis, in whom ECG changes were settled. Group B was considered as unsuccessful group to thrombolysis, in whom ECG changes remained same as before thrombolysis.Both values of C-reactive protein, CRP1 and CRP2 were compared in both groups group A and group B.
Results: Plasma CRP values before and after thrombolysis had strong predictive value for success of thrombolysis, 63.3% (P value 0.002) and 93.3% (P value <0.001) respectively.
Conclusion: In addition to ECG, C-reactive protein is a strong predictor of response of thrombolytic therapy in patients with acute myocardial infarction.