Predictive Performance of Serum Monomeric C-Reactive Protein for Major Adverse Cardiovascular Events in Patients With Acute ST-Segment Elevation Myocardial Infarction at One-Year Post-Discharge: A Retrospective Cohort Study.

AIMS/

BACKGROUND

Patients with acute ST-segment elevation myocardial infarction (STEMI) are at high risk of major adverse cardiovascular events (MACE) even after discharge, underscoring the need to identify reliable biomarkers. Therefore, this study aimed to investigate the predictive performance of serum monomeric C-reactive protein (mCRP) for MACE in patients with acute STEMI at one-year post-discharge.

METHODS

A retrospective analysis was conducted on 242 patients with acute STEMI who underwent emergency Percutaneous Coronary Intervention (PCI) in Liyang City People's Hospital between January 2021 and December 2023. Patients were divided into the MACE group (n = 58) and the non-MACE group (n = 184) based on major adverse cardiovascular events. Univariate and binary logistic regression analyses were performed to identify factors influencing MACE events in patients with acute STEMI treated with emergency PCI. Furthermore, predictive performance was assessed using receiver operating characteristic curve (ROC) analysis.

RESULTS

There were no statistically significant differences (p > 0.05) between the groups in terms of age, gender, body mass index (BMI), smoking history, alcohol consumption history, history of hypertension, left ventricular end-diastolic diameter (LVEDD), total cholesterol (TC), triglycerides (TG), B-type natriuretic peptide (BNP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and left ventricular end-diastolic volume (LVEDV). Comparisons of mCRP (within 24 hours of admission), left ventricular ejection fraction (LVEF), and cardiac troponin I (cTnI) showed statistically significant differences (p < 0.05). Monomeric CRP demonstrated a positive correlation with cTnI levels (r = 0.196, p < 0.05). Binary logistic regression analysis identified mCRP, LVEF, and cTnI levels as independent predictors of one-year post-discharge MACE in patients with acute STEMI (p < 0.05). ROC analysis yielded an area under the curve of 0.840 for mCRP (standard error = 0.028; 95% CI, 0.785-0.896, p < 0.001). At the Youden index of 0.50, mCRP demonstrated a sensitivity of 77.59%, and a specificity of 72.83%.

CONCLUSION

Monomeric CRP exhibits superior predictive performance for MACE in acute STEMI patients at one-year post-discharge.