C‐reactive protein as a marker for active coronary artery disease in patients with chest pain in the emergency room

Abstract

SummaryBackground: Markers of inflammation, such as C-reactive protein (CRP), were found to be related to risk for cardiovascular disease (CVD) events in patients with angina pectoris. In addition, recent studies have shown that, in the case of atherosclerosis, increased CRP concentration reflects the inflammatory condition of the vascular wall.Hypothesis: The study was undertaken to determine whether CRP levels in individuals with chest pain attending the emergency room (ER) may be used as a marker of active CVD.Methods: Serum CRP level was measured in 226 of 326 consecutive patients (128 men, 98 women; mean age 61.3 ± 5.9 years; range 19-87 years) referred to the ER with chest pain. The decision whether to admit or release the subjects was determined without taking the CRP level into account. Follow-up was then performed for 1 year.Results: Eighty-four patients were admitted to the hospital. Of these, 9 with acute coronary syndrome (ACS) had very high levels of CRP (25-40 mg/l), 35 had had an acute coronary event within the preceding 3 months, with levels of CRP 14-20 mg/l. Only eight patients with nonsignificant CVD had elevated CRP levels. Twenty-eight subjects who were released from the ER had elevated CRP levels (7-14 mg/l); 8 of these, in addition to 4 subjects with normal CRP levels, had a late coronary event.

Importância da proteína C-reativa no diagnóstico e no prognóstico intra-hospitalar em pacientes com dor torácica na sala de emergência

“…Such data suggest that CRP level on admission may be a ACS marker to identify patients at higher risk of developing AMI 20 . Higher CRP level in the group of patients with ACS compared with the other patients experiencing chest pain was also found in another study 21 .…”

The Electrical T-Axis and the Spatial QRS-T Angle Are Independent Predictors of Long-Term Mortality in Patients Admitted with Acute Ischemic Chest Pain

“…Simultaneously, patients presenting with elevated troponins have an increased risk of more serious ischemic complications during short- and long-term follow-up [31]. A more or less similar situation exists with regard to C-reactive protein, a marker of inflammation [32, 33], and brain natriuretic peptide, a circulating cardiac hormone [34]. Our data fit nicely with this development, as the vectorcardiographic variables under investigation had both diagnostic and prognostic impact.…”

Elevated serum interleukin-6 is predictive of coronary artery disease in intermediate risk overweight patients referred for coronary angiography

“…Lindmark et al [ 27 ] have tested this hypothesis in patients with unstable coronary artery disease and found that high circulating IL-6 identifies patients who benefit most from a strategy of early invasive management. Differently than IL-6, hs-CRP has a strong negative predictive value in patients with chest pain in the emergency room [ 28 ]. Testing the combination of these two inflammatory markers could bring interesting results.…”