C-reactive protein, infarct size, microvascular obstruction, and left-ventricular remodelling following acute myocardial infarction

Eur Heart J. 2009 May;30(10):1180-6. doi: 10.1093/eurheartj/ehp070. Epub 2009 Mar 19.


Aims: This study assessed the relationship between inflammatory mediators and indices of infarct size and left-ventricular (LV) remodelling following successful primary percutaneous coronary intervention (PCI) in patients with first time ST elevation myocardial infarction (MI).

Methods and results: Forty-two patients admitted with an occluded single vessel were recruited consecutively. Cardiac magnetic resonance was used for serial assessment (2 days, 1 week, 2 months) of infarct size, microvascular obstruction (MO), and LV remodelling. Inflammatory mediators were analysed before and after PCI. Our major findings were: (1) Following PCI, there was a marked increase in plasma levels of C-reactive protein, closely correlated with an increase in interleukin-6 and terminal complement complex, reaching maximum 2 days after PCI; (2) C-reactive protein 2 days after PCI was significantly correlated with infarct size and parameters of LV remodelling 2 months after PCI; (3) Patients with persistent MO had significantly higher C-reactive protein levels 2 days following PCI.

Conclusion: We suggest that the rapid increase in C-reactive protein levels in this model of successful revascularization of a single, totally occluded vessel reflects the degree of inflammation within the infarcted area. Our findings support a role for C-reactive protein-mediated complement activation as both a marker and mediator of myocardial damage following MI. Clinical study no.: NCT 00465868.

Trial registration: ClinicalTrials.gov NCT00465868.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • C-Reactive Protein / metabolism*
  • Complement Membrane Attack Complex / metabolism
  • Coronary Circulation
  • Electrocardiography
  • Female
  • Humans
  • Inflammation Mediators / metabolism
  • Interleukin-6 / metabolism
  • Magnetic Resonance Imaging / methods
  • Male
  • Microcirculation
  • Middle Aged
  • Myocardial Infarction* / metabolism
  • Myocardial Infarction* / pathology
  • Myocardial Infarction* / therapy
  • Prospective Studies
  • Sample Size
  • Statistics, Nonparametric
  • Stents
  • Time Factors
  • Troponin T / blood
  • Troponin T / metabolism
  • Ventricular Remodeling*


  • Complement Membrane Attack Complex
  • Inflammation Mediators
  • Interleukin-6
  • Troponin T
  • C-Reactive Protein

Associated data

  • ClinicalTrials.gov/NCT00465868