Predicting outcomes in acute coronary syndrome using biochemical markers

• Main Authors: P. Karki, K.K. Agrawaal, M. Lamsal, N.R. Shrestha
• Format: Article
• Language: English
• Published: Elsevier 2015-11-01
• Series: Indian Heart Journal
• Subjects: Acute coronary syndrome; Biochemical markers; High sensitivity C-reactive protein (hs-CRP); Estimated glomerular filtration rate (eGFR); Predicting outcome
• Online Access: http://www.sciencedirect.com/science/article/pii/S0019483215002552

Objectives: To assess risk prediction in patients with acute coronary syndrome (ACS) during the hospital stay, at 6 weeks and at 6 months period using high sensitivity C-reactive protein (hs-CRP), serum creatinine, cardiac troponin I, creatine kinase total, and MB levels. Methods: It was a prospective observational study. The primary outcome was taken as all-cause mortality. Patients with ACS were enrolled and followed up at 6 weeks and 6 months duration from the index event. Mortality and cause of death were recorded. The hs-CRP was estimated on admission, at 6 weeks, and at 6 months. The estimated glomerular filtration rate (eGFR) was calculated using the abbreviated modification of diet in renal disease (MDRD) formula at admission, at 6 weeks, and 6 months. Results: There were a total of 108 cases of ACS in the duration of 6 months who completed the follow-up. The hs-CRP level of >5 mg/dl was highly significant for predicting mortality during hospital stay and at 6 weeks (p < 0.001). There was 11% of in-hospital mortality (p < 0.001). At 6 months, the overall mortality was 28% (p < 0.001). There was a statistical significance with low eGFR (median eGFR 45 ml/min/1.73 m2) levels during the admission. Conclusion: hs-CRP levels above 5 mg/dl and the eGFR levels ≤30 ml/min/1.73 m2 were significant in predicting mortality of the patients with ACS. This may provide simple assessment tools for predicting outcome in ACS in resource-poor settings if validated further.