Are the Parameters of Inflammation a Measure of Success of Thrombolytic Treatment in Acute Myocardial Infarction?

In the present study, we investigated the role of pre-treatment highly sensitive C reactive protein (hsCRP) and serum amyloid A (SAA) levels in predicting the success of thrombolytic treatment in patients with acute ST elevation myocardial infarction STEMI. Forty two patients (4 female and 38 male) between the ages of 28 and 70 (mean age 54.8 ± 9.4 years) treated for STEMI were included in the study. After serum samples were collected for the assessment of CK-MB, troponin T, lipids, hsCRP and SAA levels, the patients were all given thrombolytic treatment. Electrocardiography obtained at presentation and 3 hours later were evaluated. An ST segment resolution 70% and above with respect to the initial ST elevation was accepted as complete resolution, while resolution values of respectively 31-69% and 0-30% were designated as moderate and weak resolution. On their 5th day of hospitalization, a second serum sample was collected from all patients for the determination of hsCRP and SAA values. Their coronary angiography and TIMI flow patterns were also evaluated. There was an inverse relationship between the initial hsCRP and SAA levels on one hand and the ST resolution after thrombolytic treatment on the other, which persisted at the 5th day after presentation. Complete resolution was predicted with a sensitivity of 67% and a specificity of 74% in patients with hsCRP levels below 3.5 mg/dl. Conversely, for patients with hsCRP values above 7.0 mg/dl, poor ST resolution was predicted with a sensitivity of 70% and a specificity of 88%. Serum hsCRP level measured before thrombolytic therapy in patients with AMI with ST elevations is a practical and reliable method in determining the efficacy of thrombolytic treatment. (Türk Kardiyol Dern Arş 2004; 32: 603-610)