The Korean Journal of Internal Medicine · Published 2026-07-01 · DOI 10.3904/kjim.2025.382
Seok-Woo Seong, Hyun Woong Park, Jae-Hwan Lee, Jin-Ok Jeong, Mi Joo Kim, Pil Sang Song, Seon-Ah Jin, Kye Taek Ahn, Myung Ho Jeong, Sang Hyun Park, Jin-Yong Hwang, KAMIR Investigators
Background/Aims Residual 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. Methods We 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. Results Among 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. Conclusions In 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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Seong, S., Park, H., Lee, J., et al. (2026). Prognostic significance of 1-year versus baseline high-sensitivity C-reactive protein after acute myocardial infarction: nationwide landmark results. The Korean Journal of Internal Medicine. https://doi.org/10.3904/kjim.2025.382