{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:12:29Z","timestamp":1792465949427,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T00:00:00Z","timestamp":1576108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centro Cardiologico Monzino, IRCCS, Milan, Italy","award":["R520-CCM549"],"award-info":[{"award-number":["R520-CCM549"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background. Accumulating evidence suggests that inflammation plays a key role in acute kidney injury (AKI) pathogenesis. We explored the relationship between high-sensitivity C-reactive protein (hs-CRP) and AKI in acute myocardial infarction (AMI). Methods. We prospectively included 2,063 AMI patients in whom hs-CRP was measured at admission. AKI incidence and a clinical composite of in-hospital death, cardiogenic shock, and acute pulmonary edema were the study endpoints. Results. Two-hundred-thirty-four (11%) patients developed AKI. hs-CRP levels were higher in AKI patients (45 \u00b1 87 vs. 16 \u00b1 41 mg\/L; p &lt; 0.0001). The incidence and severity of AKI, as well as the rate of the composite endpoint, increased in parallel with hs-CRP quartiles (p for trend &lt;0.0001 for all comparisons). A significant correlation was found between hs-CRP and the maximal increase of serum creatinine (R = 0.23; p &lt; 0.0001). The AUC of hs-CRP for AKI prediction was 0.69 (p &lt; 0.001). At reclassification analysis, addition of hs-CRP allowed to properly reclassify 14% of patients when added to creatinine and 8% of patients when added to a clinical model. Conclusions. In AMI, admission hs-CRP is closely associated with AKI development and severity, and with in-hospital outcomes. Future research should focus on whether prophylactic renal strategies in patients with high hs-CRP might prevent AKI and improve outcome.<\/jats:p>","DOI":"10.3390\/jcm8122192","type":"journal-article","created":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T11:06:41Z","timestamp":1576148801000},"page":"2192","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study"],"prefix":"10.3390","volume":"8","author":[{"given":"Nicola","family":"Cosentino","sequence":"first","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Genovese","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeness","family":"Campodonico","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bonomi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Lucci","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Milazzo","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Moltrasio","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Biondi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Riggio","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9378-8874","authenticated-orcid":false,"given":"Fabrizio","family":"Veglia","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Ceriani","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Celentano","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1955-747X","authenticated-orcid":false,"given":"Monica","family":"De Metrio","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Rubino","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio L.","family":"Bartorelli","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"},{"name":"Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d, University of Milan, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Marenzi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1136\/heartjnl-2015-307773","article-title":"Acute kidney injury in patients with acute coronary syndromes","volume":"101","author":"Marenzi","year":"2015","journal-title":"Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.amjcard.2012.11.046","article-title":"Incidence and relevance of acute kidney injury in patients hospitalized with acute coronary syndromes","volume":"111","author":"Marenzi","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.jacc.2004.07.043","article-title":"Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction","volume":"44","author":"Marenzi","year":"2004","journal-title":"J. Am. Coll Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"170","DOI":"10.7326\/0003-4819-150-3-200902030-00006","article-title":"Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality","volume":"150","author":"Marenzi","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s10557-017-6766-6","article-title":"The Incidence and the prognostic impact of acute kidney injury in acute myocardial infarction patients: Current preventive strategies","volume":"32","author":"Kaltsas","year":"2018","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jcin.2011.08.017","article-title":"Prevention of contrast nephropathy by furosemide with matched hydration: The MYTHOS (Induced Diuresis With Matched Hydration Compared to Standard Hydration for Contrast Induced Nephropathy Prevention) trial","volume":"5","author":"Marenzi","year":"2012","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"ITC66","DOI":"10.7326\/AITC201711070","article-title":"Acute kidney injury","volume":"167","author":"Levey","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1681\/ASN.2015030261","article-title":"Acute Dialysis Quality Initiative Consensus XIII Work Group. Inflammation in AKI: Current understanding, key questions, and knowledge gaps","volume":"27","author":"Rabb","year":"2016","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jclinane.2014.09.011","article-title":"New insights into the mechanisms of acute kidney injury in the Intensive Care Unit","volume":"27","author":"Glodowski","year":"2015","journal-title":"J. Clin. Anesth."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.3389\/fphar.2019.01192","article-title":"Inflammation in Renal Diseases: New and Old Players","volume":"10","author":"Watanabe","year":"2019","journal-title":"Front. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.3389\/fimmu.2018.01351","article-title":"Dissociation of C-reactive protein localizes and amplifies inflammation: Evidence for a direct biological role of C-reactive protein and its conformational changes","volume":"9","author":"McFadyen","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1172\/JCI116336","article-title":"Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in health and disease","volume":"91","author":"Vigushin","year":"1993","journal-title":"J. Clin. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.kint.2016.06.010","article-title":"C-reactive protein promotes acute kidney injury via Smad3-dependent inhibition of CDK2\/cyclin E","volume":"90","author":"Lai","year":"2016","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"754","DOI":"10.3389\/fimmu.2018.00754","article-title":"Role of C-reactive protein at sites of inflammation and infection","volume":"9","author":"Sproston","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/nep.13454","article-title":"Role of C-reactive protein in the pathogenesis of acute kidney injury","volume":"23","author":"Tang","year":"2018","journal-title":"Nephrology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1373\/clinchem.2006.070904","article-title":"Point: High-sensitivity C-reactive protein and cardiac C-reactive protein assays: Is there a need to differentiate?","volume":"52","author":"Rifai","year":"2006","journal-title":"Clin. Chem."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1161\/CIRCULATIONAHA.117.029870","article-title":"Acute coronary syndromes: The way forward from mechanisms to precision treatment","volume":"136","author":"Crea","year":"2017","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jacc.2013.05.016","article-title":"High-sensitivity C-reactive protein and cardiovascular disease: A resolute belief or an elusive link?","volume":"62","author":"Yousuf","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1159\/000329534","article-title":"C-reactive protein and the risk of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention","volume":"34","author":"Gao","year":"2011","journal-title":"Am. J. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.athoracsur.2017.01.075","article-title":"C-reactive protein predicts acute kidney injury and death after coronary artery bypass grafting","volume":"104","author":"Han","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1007\/s10157-014-1071-1","article-title":"High sensitive C-reactive protein and the risk of acute kidney injury among ST-elevation myocardial infarction patients undergoing primary percutaneous intervention","volume":"19","author":"Shacham","year":"2015","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"572","DOI":"10.2337\/dc15-0257","article-title":"The association of multiple biomarkers of iron metabolism and type 2 diabetes - the EPIC-InterAct Study","volume":"39","author":"Podmore","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"Modification of Diet in Renal Disease Study Group. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group","volume":"130","author":"Levey","year":"1999","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"R31","DOI":"10.1186\/cc5713","article-title":"Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury","volume":"11","author":"Mehta","year":"2007","journal-title":"Crit. Care"},{"key":"ref_25","first-page":"187","article-title":"The heart in sepsis: From basic mechanisms to clinical management","volume":"11","author":"Rudiger","year":"2013","journal-title":"Curr. Vasc. Pharmacol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1164\/rccm.201211-1983OC","article-title":"Mechanisms of cardiac and renal dysfunction in patients dying of sepsis","volume":"187","author":"Takasu","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1161\/CIRCRESAHA.116.309792","article-title":"Diagnostic and prognostic utility of circulating cytochrome c in acute myocardial infarction","volume":"119","author":"Marenzi","year":"2016","journal-title":"Circ. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/978-1-4939-7274-6_28","article-title":"Structural equation modeling","volume":"1666","author":"Stein","year":"2017","journal-title":"Methods Mol. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"795","DOI":"10.7326\/0003-4819-150-11-200906020-00007","article-title":"Advances in measuring the effect of individual predictors of cardiovascular risk: The role of reclassification measures","volume":"150","author":"Cook","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1161\/CIRCULATIONAHA.110.970160","article-title":"Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators. Associations between acute kidney injury and cardiovascular and renal outcomes after coronary angiography","volume":"123","author":"James","year":"2011","journal-title":"Circulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e008122","DOI":"10.1161\/JAHA.117.008122","article-title":"Acute kidney injury in diabetic patients with acute myocardial infarction: Role of acute and chronic glycemia","volume":"7","author":"Marenzi","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e003522","DOI":"10.1161\/JAHA.116.003522","article-title":"Acute kidney injury definition and in-hospital mortality in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction","volume":"5","author":"Marenzi","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.lungcan.2018.07.009","article-title":"Acute kidney injury after lung cancer surgery: Incidence and clinical relevance, predictors, and role of N-terminal pro B-type natriuretic peptide","volume":"123","author":"Cardinale","year":"2018","journal-title":"Lung Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1161\/CIRCRESAHA.111.262477","article-title":"Identification and predictive value of interleukin-6+ interleukin-10+ and interleukin-6\u2212 interleukin-10+ cytokine patterns in ST-elevation acute myocardial infarction","volume":"111","author":"Ammirati","year":"2012","journal-title":"Circ. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.5114\/aoms.2017.69327","article-title":"C-reactive protein levels predict systolic heart failure and outcome in patients with first ST-elevation myocardial infarction treated with coronary angioplasty","volume":"13","author":"Stumpf","year":"2017","journal-title":"Arch. Med. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.amjcard.2005.03.069","article-title":"Impact and determinants of left ventricular function in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction","volume":"96","author":"Halkin","year":"2005","journal-title":"Am. J. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1016\/j.jacc.2003.06.001","article-title":"TIMI Study Group Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality","volume":"42","author":"Gibson","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/j.ahj.2007.02.018","article-title":"Impact of cardiac and renal dysfunction on inhospital morbidity and mortality of patients with acute myocardial infarction undergoing primary angioplasty","volume":"153","author":"Marenzi","year":"2007","journal-title":"Am. Heart J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1161\/01.ATV.0000242794.65541.02","article-title":"C-reactive protein alters antioxidant defenses and promotes apoptosis in endothelial progenitor cells","volume":"26","author":"Fujii","year":"2006","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1016\/j.amjcard.2015.09.016","article-title":"Myocardial infarct size in patients on long-term statin therapy undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction","volume":"116","author":"Marenzi","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijcard.2015.01.046","article-title":"A meta-analysis of randomized controlled trials on statins for the prevention of contrast-induced acute kidney injury in patients with and without acute coronary syndromes","volume":"183","author":"Marenzi","year":"2015","journal-title":"Int. J. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s40620-019-00594-2","article-title":"C-reactive protein velocity and the risk of acute kidney injury among ST-elevation myocardial infarction patients undergoing primary percutaneous intervention","volume":"32","author":"Zahler","year":"2019","journal-title":"J. Nephrol."},{"key":"ref_44","first-page":"1638","article-title":"Protein to albumin ratio predicts acute kidney injury in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention","volume":"28","author":"Rencuzogullari","year":"2018","journal-title":"Heart Lung Circ."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/12\/2192\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:41:41Z","timestamp":1760190101000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/12\/2192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,12]]},"references-count":44,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["jcm8122192"],"URL":"https:\/\/doi.org\/10.3390\/jcm8122192","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,12]]}}}