ArticleThe Korean journal of internal medicine2026
Prognostic significance of 1-year versus baseline high-sensitivity C-reactive protein after acute myocardial infarction: nationwide landmark results.
Article in The Korean journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimsResidual inflammatory risk after acute myocardial infarction (AMI) remains an important determinant of long-term outcomes despite optimal lipid-lowering therapy. The prognostic significance of serial high-sensitivity C-reactive protein (hs-CRP) measurements beyond the acute phase remains unclear. This study compared baseline and 1-year hs-CRP for predicting 3-year major adverse cardiovascular events in patients with AMI undergoing percutaneous coronary intervention.
methodsWe analyzed a large prospective AMI registry in which hs-CRP was measured at baseline and 1 year, classifying patients at each time point using a ≥ 2 mg/L threshold. The primary endpoint was 3-year MACE, including cardiovascular death, recurrent myocardial infarction, stroke, repeat revascularization, and stent thrombosis.
resultsAmong 16,371 patients, 9,618 (58.8%) had elevated hs-CRP at baseline. Of the 5,389 patients with 1-year data, 28.9% had elevated hs-CRP. Baseline hs-CRP predicted MACE within the first year (hazard ratio [HR] 1.38, 95% CI 1.21-1.57); however, this association was no longer significant beyond 1 year. One year hs-CRP independently predicted subsequent 2-year MACE (HR 1.33, 95% CI 1.01-1.77). Patients with persistently high hs-CRP (≥ 2 mg/L at both time points) had the highest 3-year MACE risk (HR 1.49, 95% CI 1.08-2.06, p = 0.015 vs. persistently low group) than patients with recovered, worsening, and persistently low hs-CRP.
conclusionIn patients with AMI, hs-CRP measured at 1-year provides stronger long-term prognostic information than that at baseline beyond 1 year. Routine assessment of hs-CRP may improve risk stratification and guide targeted anti-inflammatory strategies in secondary prevention.
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