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      Relationship between high sensitivity C-reactive protein and angiographic severity of coronary artery disease

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          Abstract

          Background

          Coronary artery disease (CAD) remains a leading cause of morbidity and mortality. Cytokines play a potential role in atherosclerosis pathogenesis and progression. We investigated the association between high sensitive C-reactive protein (hsCRP) and severity of CAD.

          Methods

          CAD patients were stratified according to hsCRP cut-off value into high levels hsCRP group (≥ 8.4 mg/L) and low levels hsCRP group (< 8.4 mg/L). Severity of CAD was assessed according to artery stenosis degree and the number of vessel involved. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS, version 23.0).

          Results

          The mean age was 60.3 ± 11.0 years. The level of hsCRP was increased and ranged from 0.2 to 1020.0 mg/L. Biochemical risk factors and severity of CAD didn't show significant differences between the two groups. In multivariate linear analysis, cardiac troponin I (cTnI) and serum amyloid A (SAA) were predictors of hsCRP. As shown in receiver operating characteristic (ROC) curve analysis performed in patients with ST-segment elevation myocardial infarction (STEMI) and compared to myonecrosis biomarkers, hsCRP (area under the curve (AUC): 0.905; 95%CI: 0.844–0.966; P < 0.001) could be a powerful predictor marker in evaluating the infarct size after myocardial infarction but not better than cTnI.

          Conclusions

          HsCRP levels were not associated with the severity of CAD but could be useful in the evaluation of myocardial necrosis in patients with STEMI.

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          Most cited references31

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          Hs-CRP and all-cause, cardiovascular, and cancer mortality risk: A meta-analysis.

          Zhizhong Wang, Ruili He, Qilin Wan … (2017)
          Inconsistent findings have been reported on the association between high-sensitivity C-reactive protein (hs-CRP) and mortality risk. The objective of this meta-analysis was to investigate the association of elevated baseline hs-CRP levels with all-cause, cardiovascular, and cancer mortality risk in the general population.
          Article 0 comments Cited 143 times – based on 0 reviews     Review now
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            Biomarkers in acute myocardial infarction

            Daniel Chu Siong CHAN, Leong L Ng (2010)
            Myocardial infarction causes significant mortality and morbidity. Timely diagnosis allows clinicians to risk stratify their patients and select appropriate treatment. Biomarkers have been used to assist with timely diagnosis, while an increasing number of novel markers have been identified to predict outcome following an acute myocardial infarction or acute coronary syndrome. This may facilitate tailoring of appropriate therapy to high-risk patients. This review focuses on a variety of promising biomarkers which provide diagnostic and prognostic information. Heart-type Fatty Acid Binding Protein and copeptin in combination with cardiac troponin help diagnose myocardial infarction or acute coronary syndrome in the early hours following symptoms. An elevated N-Terminal Pro-B-type Natriuretic Peptide has been well validated to predict death and heart failure following a myocardial infarction. Similarly other biomarkers such as Mid-regional pro-Atrial Natriuretic Peptide, ST2, C-Terminal pro-endothelin 1, Mid-regional pro-Adrenomedullin and copeptin all provide incremental information in predicting death and heart failure. Growth differentiation factor-15 and high-sensitivity C-reactive protein predict death following an acute coronary syndrome. Pregnancy associated plasma protein A levels following chest pain predicts risk of myocardial infarction and revascularisation. Some biomarkers such as myeloperoxidase and high-sensitivity C-reactive protein in an apparently healthy population predicts risk of coronary disease and allows clinicians to initiate early preventative treatment. In addition to biomarkers, various well-validated scoring systems based on clinical characteristics are available to help clinicians predict mortality risk, such as the Thrombolysis In Myocardial Infarction score and Global Registry of Acute Coronary Events score. A multimarker approach incorporating biomarkers and clinical scores will increase the prognostic accuracy. However, it is important to note that only troponin has been used to direct therapeutic intervention and none of the new prognostic biomarkers have been tested and proven to alter outcome of therapeutic intervention. Novel biomarkers have improved prediction of outcome in acute myocardial infarction, but none have been demonstrated to alter the outcome of a particular therapy or management strategy. Randomised trials are urgently needed to address this translational gap before the use of novel biomarkers becomes common practice to facilitate tailored treatment following an acute coronary event.
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              Early C-reactive protein in the prediction of long-term outcomes after acute coronary syndromes: a meta-analysis of longitudinal studies.

              Guang He, Xin Tang, Yu Chen … (2010)
              To assess the overall effects by a meta-analysis. Electronic searches on PubMed and Ovid Medline from their start to October 2009 were carried out. Objective Cohort studies and secondary analysis of randomised controlled trials reporting the relative risk (RR) of recurrent cardiovascular events or death associated with C-reactive protein (CRP) obtained within 72 h from acute coronary syndromes (ACS) onset. Two epidemiologists independently abstracted information on study design, study and participant characteristics, level of CRP, outcomes, control for potential confounding factors and risk estimates using a standardised form. A general variance-based method was used to pool the estimates of risk. Thirteen studies containing 1364 new cases identified from 9787 patients during the follow-up periods reported the risk estimates by CRP categories. Compared with the bottom CRP category ( 10 mg/l) category of CRP values with a random-effects model, respectively. Another four and three studies reported the risk by unit of CRP or logarithmically transformed CRP. The pooled RRs (95% CI) were 1.49 (1.06 to 2.08) per 5 mg/l and 1.26 (0.95 to 1.69) per natural logarithm of CRP (mg/l), respectively. Greater early blood CRP moderately increases long-term risk of recurrent cardiovascular events or death, and may be a valuable prognostic predictor in patients after ACS.
              Article 0 comments Cited 56 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Geriatr Cardiol
                Journal ID (iso-abbrev): J Geriatr Cardiol
                Journal ID (publisher-id): JGC
                Title: Journal of Geriatric Cardiology : JGC
                Publisher: Science Press
                ISSN (Print): 1671-5411
                Publication date (Print): May 2020
                Volume: 17
                Issue: 5
                Pages: 256-263
                Affiliations
                [1 ]University of Monastir, Faculty of Pharmacy, Clinical and Molecular Biology Unit, Monastir, Tunisia
                [2 ]University of Monastir, Cardiology A Department Fattouma Bourguiba University Hospital, Cardiothrombosis Research Laboratory, Tunisia
                [3 ]University of Monastir, Cardiology B Department Fattouma Bourguiba University Hospital, Cardiothrombosis Research Laboratory, Tunisia
                Author notes
                # Correspondence to: Nadia Bouzidi, PhD, University of Monastir, Faculty of Pharmacy, Clinical and Molecular Biology Unit, UR 17ES29, 5000, Monastir, Tunisia. E-mail: nadiabouzidi1@ 123456outlook.fr
                Article
                Publisher ID: jgc-17-05-256
                DOI: 10.11909/j.issn.1671-5411.2020.05.003
                PMC ID: 7276307
                PubMed ID: 32547608
                SO-VID: 2aea087f-45ef-4129-a081-6d69f5469cc3
                Copyright © Institute of Geriatric Cardiology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.

                History
                Date received : 26 November 2019
                Date revision received : 20 March 2020
                Date accepted : 6 May 2020
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: coronary artery disease,high sensitive c-reactive protein,severity
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: coronary artery disease, high sensitive c-reactive protein, severity

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