Myocardial Perfusion Imaging and C-Reactive Protein in Myocardial Ischemia: A Retrospective Single-Center Study

Abstract

Background: Inflammation is an important mechanism in atherosclerosis and plaque formation. C-reactive protein (CRP) is a common inflammatory biomarker associated with the risk of coronary heart disease. We investigated the relationship of CRP with findings from myocardial perfusion imaging (MPI). Methods: In this retrospective study, 102 consecutive patients (mean age 71 years, 68% males) who underwent MPI (for diagnostic reasons or quantification of myocardial ischemia) and CRP determination (upper limit: 6 mg/L) within 1 month from MPI were included. The patients had no infection or recent acute coronary syndrome. Results: The median CRP level was 4 mg/L (2, 10) among the study population. Patients with raised CRP had higher summed stress score (SSS) (p = 0.006) and summed rest score (SRS) (p = 0.001) and higher risk for SSS > 3 (OR 9.25, 95% CI 2.03–42.13, p = 0.001) compared to those with low CRP. The association of SSS and SRS with CRP levels was more evident in patients over 70 years (p = 0.027 and p = 0.005, respectively). No significant difference in summed difference score was shown. The two groups had no difference in other risk factors (p > 0.05 for all comparisons). Conclusion: a high level of CRP was associated with the presence and extent of stress-induced myocardial ischemia in MPI.

Systemic Impact of Subgingival Infection Control in Periodontitis Patients with Cardiovascular Disease: A Narrative Review

“…Increased circulating levels of CRP have been reported in periodontitis [73][74][75] as well as in CVD patients [61,76]. Subclinical inflammation, as indicated by plasma CRP levels, was associated not only with the presence of coronary atherosclerosis but also with the severity of coronary plaque burden and the clinical manifestation of ischemia [77]. Furthermore, even a slight yet persistent increase in CRP or high-sensitivity CRP (hs-CRP) has been correlated with the presence of coronary artery disease and a heightened risk of future cardiovascular events among apparently healthy individuals [78].…”

“…Furthermore, even a slight yet persistent increase in CRP or high-sensitivity CRP (hs-CRP) has been correlated with the presence of coronary artery disease and a heightened risk of future cardiovascular events among apparently healthy individuals [78]. Considering the systemic risks associated with increased serum CRP levels [77,78] and the observed decrease in CRP concentrations following nonsurgical therapy in periodontitis patients with concurrent CVD [43,46,60], immediate infection control in these individuals is imperative.…”