Aim and objective: The goal of this study was to examine the association of high-sensitive C-reactive protein (hs-CRP) and lipid profile within 24 hours of onset of symptoms in acute coronary syndrome (ACS) patients.
Materials and methods: We studied 300 patients with ACS and 100 age- and sex-matched control subjects with no cardiac disease. Acute coronary syndrome patients were classified into two groups (I) onset of ACS symptoms <6 hours and (II) onset of ACS symptoms ≥6 and <24 h. Blood samples were obtained within 24 hours of hospital admission. High-sensitive C-reactive protein and lipid profile were analyzed by latex enhanced immunoturbidimetric method and enzymatic colorimetric methods, respectively.
Results: Overall serum levels of hs-CRP at the early phase of ACS were significantly higher (9.15 ± 5.89 vs 1.08 ± 0.7 mg/L, p < 0.001), along with altered lipid profile in patients than in control subjects. In subgroup analysis, serum concentrations of hs-CRP were approximately 3-fold higher in group I when compared with the control group (3.4 ± 2.08 vs 1.08 ± 0.7 mg/L, p < 0.001), and the levels of hs-CRP were almost 12-fold higher in group II than the controls (12.98 ± 4.26 vs 1.08 ± 0.7, p < 0.001). Between ACS patients subgroups, serum hs-CRP levels were almost 4-fold higher in group II when compared with group I (p < 0.001).
Conclusions: Our results demonstrate that hs-CRP is significantly higher in the patient\'s group during the early phase of ACS suggesting that inflammatory processes play a role in ACS.
Casas JP, Shah T, Hingorani AD, et al. C-reactive protein and coronary heart disease: a critical review. J Intern Med 2008;264(4):295–314. DOI: 10.1111/j.1365-2796.2008.02015.x.
Calabro P, Golia E, Yeh ET. Role of C-reactive protein in acute myocardial infarction and stroke: possible therapeutic approaches. Curr Pharm Biotechnol 2012;13(1):4–16. DOI: 10.2174/138920112798868764.
Ahmed MS, Jadhav AB, Hassan A, et al. Acute phase reactants as novel predictors of cardiovascular disease. ISRN Inflamm 2012;2012:953461. DOI: 10.5402/2012/953461.
Greenland P, Alpert JS, Beller GA, et al. ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American college of cardiology foundation/American heart association task force on practice guidelines. Circulation 2010;122(25):e584–636. DOI: 10.1161/CIR.0b013e3182051b4c.
Madjid M, Willerson JT. Inflammatory markers in coronary heart disease. Br Med Bull 2011;100(1):23–38. DOI: 10.1093/bmb/ldr043.
Bursi F, Weston SA, Killian JM, et al. CRP and heart failure after myocardial infarction in the community. Am J Med 2007;120(7):616–622. DOI: 10.1016/j.amjmed.2006.07.039.
Ingelsson E, Schaefer EJ, Contois JH, et al. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women. JAMA 2007;298(7):776–785. DOI: 10.1001/jama.298.7.776.
Pitt B, Loscalzo J, Ycas J, et al. Lipid levels after acute coronary syndromes. J Am Coll Cardiol 2008;51(15):1440–1445. DOI: 10.1016/j.jacc.2007.11.075.
Thygesen K, Alpert JS, White HD, et al. Universal definition of myocardial infarction. Circulation 2007;116(22):2634–2653. DOI: 10.1161/CIRCULATIONAHA.107.187397.
Cavusoglu Y, Gorenek B, Alpsoy S, et al. Evaluation of C-reactive protein, fibrinogen and anti-thrombin III as risk factors for coronary artery disease. Isr Med Assoc J 2001;3(1):13–16.
Yip HK, Wu CJ, Chang HW, et al. Levels and values of serum high-sensitivity C-reactive protein within 6 hours after the onset of acute myocardial infarction. Chest 2004;126(5):1417–1422. DOI: 10.1378/chest.126.5.1417.
Sheikh AS, Yahya S, Sheikh NS, et al. C-reactive protein as a predictor of adverse outcome in patients with acute coronary syndrome. Heart Views 2012;13(1):7–12. DOI: 10.4103/1995-705X.96660.
He LP, Tang XY, Ling WH, et al. Early C-reactive protein in the prediction of long-term outcomes after acute coronary syndromes: a meta-analysis of longitudinal studies. Heart 2010;96(5):339–346. DOI: 10.1136/hrt.2009.174912.
Swiatkiewicz I, Kozinski M, Magielski P, et al. Value of CRP in predicting left ventricular remodeling in patients with a first ST-segment elevation myocardial infarction. Mediators Inflamm 2012;2012:250867. DOI: 10.1155/2012/250867.
Otter W, Winter M, Doering W, et al. C-reactive protein in diabetic and nondiabetic patients with acute myocardial infarction. Diabetes Care 2007;30(12):3080–3082. DOI: 10.2337/dc07-1020.
Cui R, Iso H, Toyoshima H, et al. Serum total cholesterol levels and risk of mortality from stroke and CHD in Japanese: the JACC study. Atherosclerosis 2007;194(2):415–420. DOI: 10.1016/j.atherosclerosis.2006.08.022.
Gorecki A, Bednarz B, Jaxa-Chamiec T, et al. Lipid profile during the first 24 hours after myocardial infarction has significant prognostic value. Kardiol Pol 2004;60(3):229–236.
Wattanasuwan N, Khan IA, Gowda RM, et al. Effect of acute myocardial infarction on cholesterol ratios. Chest 2001;120(4):1196–1199. DOI: 10.1378/chest.120.4.1196.
Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart association task force on practice guidelines (writing committee to revise the 2002 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction). J Am Coll Cardiol 2007;50(7):e1–e157. DOI: 10.1016/j.jacc.2007.02.013.
Miller M. Lipid levels in the post-acute coronary syndrome setting: destabilizing another myth? J Am Coll Cardiol 2008;51(15):1446–1447. DOI: 10.1016/j.jacc.2007.12.039.