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The prognosis and outcomes of patients with a ST-segment elevation myocardial infarction and the biochemical and clinical inflammatory response Open Access


Other title
myocardial infarction
Type of item
Degree grantor
University of Alberta
Author or creator
van Diepen, Sean
Supervisor and department
Ezekowitz, Justin A (Medicine)
Examining committee member and department
Tsuyuki, Ross T (Medicine)
Newby, L. Kristin (Medicine, Duke University)
Ezekowitz, Justin A (Medicine)
McAlister, Finlay A (Medicine)
Department of Medicine
Experimental Medicine
Date accepted
Graduation date
Master of Science
Degree level
Acute myocardial infarction, and specifically coronary plaque rupture, has been associated with a systemic inflammatory cascade. Using multiple large clinical trial datasets, we sought to further understand the systemic and clinical inflammatory responses in patients with ST-elevation myocardial infarction (STEMI) and have three key findings. First, the systemic inflammatory response syndrome (SIRS) was associated with 90-day clinical outcomes. Second, interleukin (IL)-6 was modestly correlated with NT-proBNP suggesting that NT-proBNP may be expressed in response to systemic inflammatory stimuli. Third, although multiple inflammatory biomarkers independently predicted 90-day clinical outcomes, they added little value to a clinical prediction model that included N-terminal B-type natriuretic peptide (NT-proBNP). These findings reinforce the importance of the inflammatory response in STEMI in relation to both clinical outcomes and possible linkages to inflammatory biomarker expression and the natriuretic peptide system.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
Van Diepen S, et al. Critical Care Medicine 2013 (in press)Van Diepen S ,et al. International Journal of Cardiology 2013;
Diepen S, et al. Journal of Thrombosis and Thrombolysis 2012; 34(1):106-113.

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