Serum Amyloid A Protein as a Predictor of Cardiac Rupture in Acute Myocardial Infarction Patients Following Primary Coronary Angioplasty(CLINICAL INVESTIGATION) Katayama Toshiro Nakashima Hiroshi Takagi Chisa Honda Yukiharu Suzuki Shin Iwasaki Yoshihiro Yamamoto Tadashi Yoshioka Masato Yano Katsusuke 社団法人日本循環器学会 Circulation journal : official journal of the Japanese Circulation Society 13469843 70 5 530 535 2006-04-20 Background The predictors of cardiac rupture (CR) in patients with acute myocardial infarction (AMI) treated with successful primary coronary angioplasty have not been identified. Methods and Results Of 433 consecutive AMI subjects who underwent reperfusion by primary coronary angioplasty within 24h of onset, CR occurred in 11 (2.5%), free wall rupture in 9, and ventricular septal perforation in 2. Rates of females, diabetes mellitus and anterior infarction were higher in the group of CR patients than in the others (p<0.05). There were no significant differences between the 2 groups in terms of left ventricular (LV) function soon after recanalization, such as LV ejection fraction, regional wall motion, or end-diastolic volume index. Plasma levels of both high-sensitivity C-reactive protein (hsCRP) and serum amyloid-A protein (SAA) were significantly higher in the CR patients than in the others (hsCRP: 6.7±6.7mg/dl vs 3.3±3.8mg/dl, p=0.007; SAA: 699±812μg/dl vs 208±273μg/dl, p<0.0001). Multivariate analysis identified SAA as an independent predictor of CR (risk ratio: 8.8, 95% confidence interval: 1.7-25.6, p<0.05). Conclusions In patients with AMI treated with primary coronary angioplasty, inflammation may be closely related to CR, for which SAA is a useful predictor. 2006-04-20 110004720669 AA11591968 ENG CJP CJPref NII-ELS J-STAGE 3 29 1 Serum Amyloid A Protein as a Predictor of Cardiac Rupture in Acute Myocardial Infarction Patients Following Primary Coronary Angioplasty(CLINICAL INVESTIGATION) Katayama Toshiro Nakashima Hiroshi Takagi Chisa Honda Yukiharu Suzuki Shin Iwasaki Yoshihiro Yamamoto Tadashi Yoshioka Masato Yano Katsusuke Japanese Circulation Society Circulation journal : official journal of the Japanese Circulation Society Background The predictors of cardiac rupture (CR) in patients with acute myocardial infarction (AMI) treated with successful primary coronary angioplasty have not been identified. Methods and Results Of 433 consecutive AMI subjects who underwent reperfusion by primary coronary angioplasty within 24h of onset, CR occurred in 11 (2.5%), free wall rupture in 9, and ventricular septal perforation in 2. Rates of females, diabetes mellitus and anterior infarction were higher in the group of CR patients than in the others (p<0.05). There were no significant differences between the 2 groups in terms of left ventricular (LV) function soon after recanalization, such as LV ejection fraction, regional wall motion, or end-diastolic volume index. Plasma levels of both high-sensitivity C-reactive protein (hsCRP) and serum amyloid-A protein (SAA) were significantly higher in the CR patients than in the others (hsCRP: 6.7±6.7mg/dl vs 3.3±3.8mg/dl, p=0.007; SAA: 699±812μg/dl vs 208±273μg/dl, p<0.0001). Multivariate analysis identified SAA as an independent predictor of CR (risk ratio: 8.8, 95% confidence interval: 1.7-25.6, p<0.05). Conclusions In patients with AMI treated with primary coronary angioplasty, inflammation may be closely related to CR, for which SAA is a useful predictor. Katayama Toshiro Department of Cardiovascular Medicine and Course of Medical and Dental Science, Graduate School of Biomedical Science, Nagasaki University Nakashima Hiroshi Department of Cardiology, Nagasaki Citizens Hospital Takagi Chisa Department of Cardiology, Nagasaki Citizens Hospital Honda Yukiharu Department of Cardiology, Nagasaki Citizens Hospital Suzuki Shin Department of Cardiology, Nagasaki Citizens Hospital Iwasaki Yoshihiro Department of Cardiology, Nagasaki Kouseikai Hospital Yamamoto Tadashi Department of Cardiology, Nagasaki Kouseikai Hospital Yoshioka Masato Department of Cardiology, Nagasaki Kouseikai Hospital Yano Katsusuke Department of Cardiovascular Medicine and Course of Medical and Dental Science, Graduate School of Biomedical Science, Nagasaki University