Elevated high-sensitivity C-reactive protein (hsCRP) and low body mass index (BMI) are linked to increased mortality in the elderly population. However, the combined value for predicting adverse cardiovascular events in the oldest-old (≥80 years old) with acute myocardial infarction (AMI) remains undetermined. A total of 463 AMI patients, who were ≥80 years old, were enrolled in this study between January 2012 and June 2017. A nested case-control study was implemented in 106 deaths and 212 controls, who were matched for age, gender, time of inclusion, and myocardial infarction type. Furthermore, the individual and additive values of hsCRP, BMI, and left ventricular ejection fraction (LVEF) were assessed using adjusted hazard ratio, unadjusted Kaplan-Meier analysis, and receiver-operating characteristic curve models. The median follow-up time was 19.15 months, and there were 106 deaths (33.3%). Furthermore, HsCRP, BMI, and LVEF were significantly associated with all-cause mortality (p <0.05, respectively). In addition, a negative correlation between BMI and LVEF, and the positive association of hsCRP with all-cause mortality in the fully adjusted Cox proportional hazards model were detected. The combination of hsCRP, BMI, and LVEF was found to exhibit an enhanced predictive value for all-cause mortality (0.733 in jointly vs 0.623 in cardiovascular risk factors, p = 0.0007) in these oldest-old AMI patients. HsCRP, BMI, and LVEF are the independent risk factors for all-cause mortality for the oldest-old patients with AMI, and this combination offers more appreciable and reliable predictive value for all-cause mortality.
Copyright © 2018. Published by Elsevier Inc.