Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure

Objectives: To assess the ability of C-reactive protein (CRP) to predict long-term outcomes in a chest pain population. Design and methods: CRP was measured at presentation in 446 emergency department patients with acute coronary syndromes. All-cause mortality and hospital discharges for acute myocardial infarction (AMI) and congestive heart failure (CHF) were obtained for up to 8 years following the event. Results: Kaplan-Meier analyses indicated that patients with CRP concentrations above the American Heart Association scientific statement cut-off had a higher rate for death and CHF admissions. After adjusting for troponin concentrations, in a Cox proportional hazard model, only CRP concentrations indicative of an acute phase response (i.e., > 7.44 mg/L) were associated with a significant risk for death after 5 years and CHF readmission after 2 years. Conclusions: Patients presenting early with chest pain with elevated CRP concentrations have a greater long-term risk for death and heart failure.