C-Reactive Protein in Diabetic and Nondiabetic Patients With Acute Myocardial Infarction
- Wolfgang Otter, MD12,
- Michael Winter, MD3,
- Wittich Doering, MD1,
- Eberhard Standl, MD3 and
- Oliver Schnell, MD3
- 1Cardiology, Academical Teaching Hospital, Schwabing, Munich, Germany
- 2Center of Internal Medicine, Unterschleissheim/Munich, Germany
- 3Diabetes Research Institute, Munich, Germany
- Address correspondence and reprint requests to Wolfgang Otter, MD, Center of Internal Medicine, Unterschleissheim/Munich, Rathausplatz 2, 85716 Unterschleissheim/Munich, Germany. E-mail: w.otter{at}t-online.de
Atherosclerosis has been reported to be associated with chronic low-grade inflammation of the vasculary structure and the endothelial cells (1–4). C-reactive-protein (CRP) is a marker for inflammation and is enhanced in both atherosclerosis and coronary artery disease (5–7). CRP plasma levels above the cutoff of 3 mg/l, as assessed with high-sensitivity immunoassays, have been shown to indicate an increase in cardiovascular risk (8). Diabetes is an independent risk factor of atherosclerosis (9,10). It is considered a state of low-grade inflammation (11–13). CRP levels have been reported to be augmented in diabetic patients (11–13). The Munich Myocardial Infarction Registry analyzes the outcome of hospital mortality in both diabetic and nondiabetic subjects (13,14). The present study aimed at determining the role of CRP in patients with myocardial infarction and comparing the results between diabetic and nondiabetic patients.
RESEARCH DESIGN AND METHODS
All patients of the Munich Myocardial Infarction Registry (2001–2004, n = 1,237) were included in the analysis. Myocardial infarction was defined and treated according to the recommendations of the European Society of Cardiology and the American College of Cardiology (15,16–18).
The presence of diabetes was defined if the patient had been informed of this diagnosis or was on prescribed antidiabetes treatment. Patients without diagnosis but with blood glucose ≥200 mg/dl (3) were also classified as having diabetes (14). CRP was measured on admission and analyzed by a highly sensitive CRP-Assay, (Roche Diagnostics, Basel, Switzerland).
Statistics
Group comparisons were performed by Mann-Whitney U …
