A new study published in the Cardiology Research and Practice highlights the potential role of high-sensitivity C-reactive protein (hs-CRP) in predicting the no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). The no-reflow phenomenon, characterized by inadequate myocardial perfusion despite successful opening of the coronary artery, remains a major complication of pPCI and has been associated with worse clinical outcomes.
Involving 182 STEMI patients who presented within 12 hours of symptom onset, the study aimed to evaluate the influence of hs-CRP levels on reperfusion outcomes following pPCI. Blood samples were collected at admission, and hs-CRP levels were measured using the Cobas assay. Patients were categorized based on their post-intervention thrombolysis in myocardial infarction (TIMI) flow grade into successful reperfusion (TIMI 3) and no-reflow (TIMI ≤2) groups.
The findings showed a significantly higher median hs-CRP level in patients with no-reflow (37.9 mg/L; range 1.8–271.2) compared to those with successful reperfusion (8.5 mg/L; range 0.4–268), with a p-value of <0.0001. The receiver operating characteristics (ROC) curve analysis yielded an area under the curve (AUC) of 0.73 (95% CI: 0.64–0.81), indicating moderate predictive power. A cutoff value of 18.0 mg/L for hs-CRP was statistically significant (p = 0.0001) for identifying patients at higher risk of no-reflow.