Abstract: Objective The aim of the study was to evaluate the prognostic value of the postprocedural tumor necrosis factor-α (TNF-α) and high sensitivity C-Reactive Protein(hs-CRP) in patients with first acute myocardial infarction(AMI) treated with successful percutaneous coronary intervention(PCI). Methods A total of 152 consecutive AMI patients underwent successful PCI were enrolled. TNF-α and hs-CRP were measured within 12 hours after PCI. All patients were followed up for 1 year. Logistic regerssion analysis was used to evaluate predictive values of postprocedural TNF-α and hs-CRP for MACE at 30 days and 1 year post PCI. Time-to-event analyses were performed using the Kaplan-Meier survival curves in patients with various ranges of postprocedural TNF-α and hs-CRP. Results The percentage of anterior myocardial infarction, the peak of Creatine Kinase MB, left ventricular ejection fraction, TNF-α and hs-CRP levels were all significantly different between MACE group and non-MACE group after PCI. Multivariable logistic analysis showed the OR of TNF-α were 1.43 (P=0.006) at 30 days and 1.62 (P=0.002) at 1 year. The OR of hs-CRP were 1.14 (P=0.004) at 30 days and 1.22 (P=0.005) at 1 year. The patients with higher postprocedural TNF-α level had significant lower survival rates at 30-day and at 1-year, compared with the patients with lower postprocedural TNF-α level. The patients with higher postprocedural hs-CRP level had significant lower survival rates at 1-year, compared with the patients with lower hs-CRP level. In higher TNF-α group recurrent myocardial infarction rates at 1-year, revascularization rates at 30-days and at 1-year were higher than those in lower TNF-α group. Compared with those in lower hs-CRP group, recurrent myocardial infarction rates and revascularization rates at 30-days and at 1-year all apparently increased in higher hs-CRP group. Conclusion Postprocedural TNF-α and hs-CRP levels are closely related with short and long-term MACE in first AMI patients treated with successful primary PCI.

Key words: myocardial infarction, percutaneous coronary intervention, tumor necrosis factor-α, high sensitivity C-Reactive Protein, prognosis