A Study of C Reactive Protein levels in the acute myocardial infarction and its association with outcome of the infarct.

Acute Myocardial Infarction is overwhelmingly the most important form of IHD which

continues to be the leading cause of death in the industrialized and developing countries like

India, despite spectacular progress in their prevention, detection and treatment over the last

three decades. AMI has rapidly emerged as the major contributor towards the increasing

morbidity and mortality.

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A large number of asymptomatic individuals are at serious risk of developing MI because of

their genetic predisposition, smoking behavior and sedentary lifestyle. About one third of

patients with evolving myocardial infarction die before they reach the hospital to receive any

effective treatment. Thus, myocardial infarction remains an important health problem and

merits continued attention from basic and clinical researchers, epidemiologists and practicing

physicians.

A growing body of evidence supports the concept that local and systemic inflammation play a

role in the initiation and progression of atherosclerosis and its complications. Inherent to the

inflammatory process is the occurrence of an acute phase response.2,3 This response is induced

by pro-inflammatory cytokines (Interleukin 1 and 6) which are released from the inflamed

tissue by inflammatory and / or parenchymal cells. These in turn stimulate the liver to

synthesize a number of acute phase proteins. CRP is a hepatically derived classical acute

phase reactant, the serum level of which has long been known to increase after myocardial

infarction.

CRP levels partially reflect the extent of myocardial necrosis and can be used to predict in

hospital and long terms, outcome in patients with AMI. Elevated plasma CRP levels in

patients with acute coronary syndromes on admission and its persistence after discharge may

indicate a state of persistent inflammation with poor short term and long term prognosis.

Recent studies have shown CRP to be a risk predictor for future myocardial infarction, stroke

and coronary heart disease in apparently healthy persons.

Due to the irreversibility of most acute cardiac events there is always an interest in searching

for simple tests to single out patients with bad prognosis, so that timely revascularization is

planned or they are put on intensive conservative regimens.6

This study is designed to evaluate the serum concentration of CRP in AMI and its association

with subsequent consequences in hospital morbidity and mortality.