HIGH-SENSITIVITY C-REACTIVE PROTEIN MEASUREMENTS IN PATIENTS WITH A HISTORY OF MYOCARDIAL INFARCTION- A TARGETED LITERATURE REVIEW
Author(s)
Jindal R1, Agrawal R1, Gabrielsen A2, Deschaseaux C3
1Novartis Healthcare Pvt. Ltd., Hyderabad, India, 2Novartis Sverige AB, Täby, Sweden, 3Novartis Pharma AG, Basel, Switzerland
OBJECTIVES: The incidence of cardiovascular (CV) events is high after acute myocardial infarction (MI). Chronic inflammation is a common CV risk factor in heart disease. The inflammatory marker C-reactive protein (CRP) can be measured in a high-sensitivity assay (hs-CRP) specific to cardiac inflammation. This research assessed published data on the prevalence of elevated CRP among patients with a history of MI. METHODS: A comprehensive literature search was performed for publications in English between January 2000 and February 2016 in MEDLINE, EMBASE, and MEDLINE In-Process. Search terms were variations on ‘Post myocardial infarction’, ‘CRP’ and ‘epidemiology’. Clinical and real-world studies reporting baseline CRP levels in stable patients with a history of MI were included in the analysis. RESULTS: Eight publications provided information on baseline CRP levels in patients with a history of MI. Cut-off points in hs-CRP assays varied from >2 mg/L to ≥5.9 mg/L. One publication reported 36% prevalence of CRP levels >2 mg/L; one found 49% prevalence of levels >2.3 mg/L and one analysis reported 50% prevalence of levels ≥2.37 mg/L. One analysis found 33% prevalence of CRP levels ≥2.9 mg/L. The prevalence of CRP levels >3 mg/L were reported by two publications as 27.6% and 53.7%, respectively. One study reported 38.8% prevalence of levels ≥3.3 mg/L. Levels ≥3.8 mg/L were found in 25% (one study); levels ≥4.2 mg/L in 25% (one analysis) and levels ≥5.9 mg/L in 24.7% of patients (one analysis). CONCLUSIONS: Limited data are available on the prevalence of elevated levels of CRP in patients with a history of MI. Although variations in findings, cut-off points and methods between studies make generalisations difficult, the condition appears to be common. Epidemiological studies employing the hs-CRP assay would be desirable to provide improved data on elevated CRP and CV risk in patients with a history of MI.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PCV33
Topic
Epidemiology & Public Health
Disease
Cardiovascular Disorders