C-reactive protein and the severity of atherosclerosis in myocardial infarction patients with stable angina pectoris

Abstract

Background Recent findings provide evidence for the importance of inflammatory processes in the pathogenesis of atherosclerosis. C-reactive protein was elevated in patients with peripheral artery disease, coronary heart disease and myocardial infarction compared to normal subjects. MethodsIn 1112 male and 299 female survivors of myocardial infarction (mean age SD, men, 50·4 9·5, women, 56·1 9·3), we investigated whether plasma C-reactive protein concentration is associated with the severity of coronary heart disease and generalized pre-clinical or clinically manifest arteriopathy. The control group consisted of 326 male and 138 female individuals matched for age without clinical symptoms of coronary disease. The severity of arteriosclerotic changes was determined for the extra-cranial brain-supplying arteries, abdominal aorta, pelvis and leg arteries. In myocardial infarction patients coronary angiography was performed. Laboratory analyses included determination of C-reactive protein, fibrinogen, D-dimer, HDL-cholesterol, LDL-cholesterol and triglycerides. ResultsThe following ranking of C-reactive protein concentrations was found: controlscpatients after myocardial infarction without atherosclerosiscpatients with myocardial infarction and pre-clinical atherosclerosiscpatients with myocardial infarction and clinically manifest atherosclerosis. Additionally, our data showed a significant association between C-reactive protein concentrations and the angiographically detected degree of coronary heart disease.Conclusions As C-reactive protein is a marker of inflammatory processes, our results in patients with clinically manifest and early pre-clinical atherosclerosis support the hypothesis that inflammatory processes in the vessel wall participate in atherogenesis. Moreover, they support the hypothesis of a causal relationship between an acute phase reaction and the pathogenesis of atherosclerosis in coronary arteries and other parts of the arterial vessel system.

Clinical and angiographic correlation of high-sensitivity C-reactive protein with acute ST elevation myocardial infarction

“…To the best of our knowledge, there are no previous studies correlating hs-CRP with Syntax score in STEMI. However, a few studies have correlated it with the presence and extent of severity of CAD in ACS; the present study findings corroborate earlier studies, which have shown a correlation between CRP and the severity of CAD (29,30).…”

Elevated C-Reactive Protein Constitutes an Independent Predictor of Advanced Carotid Plaques in Dyslipidemic Subjects

“…13,14 An association between CRP and the presence and number of stenosed coronary vessels has been documented in coronary atherosclerosis. [15][16][17][18][19][20] With respect to carotid atherosclerosis, 2 studies have shown a positive association between serum CRP levels and the presence of carotid plaques. 20,21 In the Bruneck Study (Willeit et al 21 ), a significant relationship between CRP and early nonstenotic atherosclerosis (Յ40% narrowing of the lumen) was restricted to univariate analysis.…”

Effects of Body Mass Index on the Lipid Profile and Biomarkers of Inflammation and a Fibrinolytic and Prothrombotic State

“…Despite evidence relating CRP-hs and CHD, the role of this protein in the development of a pathological state has not been completely established. Chronic elevation of the CRP-hs level is evident in individuals with cardiovascular disease risk factors, such as diabetes, smoking, obesity, hypertension and dyslipidemia [29][30][31] . In the current study, a significant and independent correlation was observed between the CRP-hs level and BMI, and the HDLcholesterol and CRP-hs levels were shown to be signif- …”