Relationship of C-reactive protein to presence and severity of coronary atherosclerosis in patients with stable angina pectoris or a pathological exercise test

Veselka, Josef; Procházková, Šárka; Duchoňová, Radka; Bolomová, Ingrid; Urbanová, T; Tesař, David; Honĕk, T

doi:10.1097/00019501-200205000-00003

Cited by 33 publications

(21 citation statements)

References 24 publications

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“…In our study, although basal serum hs-CRP levels were the same in the two groups, the exercise capacity of the non-ischaemic group was better than in the ischaemic group. Veleska et al could not find any relationship between serum hs-CRP levels and exercise testing results in a study that included 200 patients with positive exercise tests 8. On the other hand, Cosin-Sales et al reported a correlation between serum hs-CRP levels and ST-segment depression during exercise testing with Holter monitoring, and the frequency of angina episodes in patients with typical chest pain and normal coronary angiograms 6.…”

Section: Discussionmentioning

confidence: 99%

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Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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AimThe aim of this study was to detect any relationship between serum high-sensitivity C-reactive protein (hs-CRP), serum amyloid-associated protein (SAA) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and reversible myocardial ischaemia during cardiovascular exercise tests and to determine whether these biomarkers could predict transient myocardial ischaemia.MethodsNinety-six patients (36 women, 60 men, mean age 57 ± 8.5 years) were included in the study. Venous blood samples were taken from patients before and 15 minutes after exercise testing. SAA and hs-CRP were analysed using immunonephelometric assays (Dade-Behring, BN II, Marburg, Germany). NT-proBNP (pg/ml) was determined using the immulite 1 000 chemiluminescence immunoassay system (Siemens Medical Solution Diagnostics, Deerfiled, USA). Forty-eight patients (18 women, 30 men) with positive exercise tests were allocated to the exercise-positive group and 48 (18 women, 30 men) with negative exercise tests were put in the exercise-negative group. Coronary angiography was performed on all patients in the exercise-positive group.ResultsThere was no difference between the levels of hs-CRP, SAA and NT-pro-BNP before and after exercise testing in both of the exercise groups.ConclusionSerum levels of hs-CRP, SAA and NT-proBNP could not predict the occurrence of reversible myocardial ischaemia during exercise. Large-scale clinical studies are needed to clarify the status of hs-CRP, SAA and NT-proBNP with exercise.

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Section: Discussionmentioning

confidence: 99%

“…However, its role in predicting transient myocardial ischaemia in stable coronary heart disease is not clear. While some studies found a strong relationship between serum hs-CRP levels and reversible myocardial ischaemia in exercise electrocardiographic testing,6 others did not find such a relationship 7,8…”

Section: Discussionmentioning

confidence: 99%

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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“…We did not use angiographic data because some patients did not undergo coronary angiography, and there is no relationship between CRP levels and the extent of coronary artery disease. 33 …”

Section: Study Limitationsmentioning

confidence: 99%

Association Between Serum C‐reactive Protein Elevation and Atrial Fibrillation After First Anterior Myocardial Infarction

Gedikli¹,

Örem²,

Baykan³

et al. 2008

Clinical Cardiology

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Background: Elevated inflammatory markers have been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that C-reactive protein (CRP) may be involved in the initiation process of atrial fibrillation (AF). However, the role of CRP levels in the occurence of AF in patients with AMI has not been studied. This study investigated whether CRP is a risk factor for AF in patients with acute anterior MI. Methods: We prospectively evaluated 92 consecutive patients (25 women and 67 men; aged 58±11 y) with a first acute anterior wall MI. Blood samples were obtained at the time of admission to the hospital, and serum CRP levels were measured by an ultrasensitive immunonephelometry method. All patients were evaluated by echocardiography to measure the left ventricular (LV) diameter and functions. All patients were monitored continuously for the detection of AF in the coronary care unit. Results: Atrial fibrillation occured in 19 (20%) of 92 patients. Univariate analysis showed that patients with AF had an advanced age (63±9.9 versus 56.7±11.7 y, p = 0.034), higher serum CRP level (2.95±2.5 versus 1.71±2.12 mg/dL, p = 0.034), larger LV end-systolic volume (74±15 versus 63±19, mL p = 0.02), higher LV ejection fraction (31.1±6.2 versus 38.4±10%, p = 0.001), and larger left atrial (LA) diameter (37.1±4.2 versus 34.7±3.3 mm, p = 0.01). In multivariate analysis, only age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1-1.11, p = 0.036) and CRP levels (OR: 1.27, 95% CI: 1-1.59, p = 0.039) were independent predictors of AF. Conclusion: These results suggest that CRP may be a risk factor for AF in patients with acute anterior wall MI.

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“…Zebrack et al (31) showed a low but significant correlation between CRP levels and the severity/ extent of coronary artery disease. Their suggestion, because CRP is weakly correlated with angiographic plaque burden, it appears that CRP is stimulated not only by the extent of atherosclerosis but, by other factors, also emphasized by Veselka et al (33) in their study, in which CRP level was not related to the extent or the presence of coronary atherosclerosis assessed by coronary angiography. It was also assumed that (19), the increase in CRP was not secondary to the extent and severity of myocardial ischemia, but might be an independent marker of the inflammatory component involved in the pathogenesis of acute coronary syndromes on the basis of clinical evidence that high concentrations of CRP in patients with UAP was associated with a worse prognosis independently of the extent and severity of myocardial ischemia.…”

Section: Discussionmentioning

confidence: 72%

“…Besides studies confirming the existing relation between CRP levels and the presence of coronary artery disease documented by coronary angiography (31,32), some studies found no correlation between the extent of coronary artery disease and CRP levels (10,29,(33)(34)(35). In respect to these studies, our first aim was to investigate the relationship between CRP and angiographic coronary artery disease in patients with unstable angina pectoris.…”

Section: Discussionmentioning

confidence: 93%

C-reactive protein in unstable angina pectoris and its relation to coronary angiographic severity and diffusion scores of coronary lesions

Soysal¹,

Karakuş²,

Hh³

et al. 2010

Anadolu Kardiyol Derg

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C-reactive protein in unstable angina pectoris and its relation to coronary angiographic severity and diffusion scores of coronary lesions Kararsız anjina pektoris'de C-reaktif protein ve bunun koroner lezyonların koroner anjiyografik şiddeti ve yaygınlık derecesi ile ilişkisi 421ÖZET Amaç: C-reaktif protein (CRP) düzeyleri ile kararsız anjina pektorisli (UAP) hastalarda koroner arter lezyonlarının yaygınlığı ve şiddeti arasında-ki ilişkiyi ve CRP'nin kararsız anjina kliniğine bağımsız etkisini araştırmaktı.Yöntemler: Enine-kesitli, gözlemsel bu çalışmaya yaşları 28-73 arasında 50 hasta alındı. Kararsız anjina sınıflaması Braunwald'a göre yapıldı. Hastaların anjiyografilerinde saptanan lezyonların şiddeti ve yaygınlığı Reardon'un modifiye skorlama yöntemi ile değerlendirildi. Plazma CRP düzeyleri immünotürbidimetrik yöntemle ölçüldü. Nonparametrik testler CRP ve diğer risk faktörlerinin karşılaştırılmasında, lojistik regresyon analizi CRP ve UAP arasındaki bağımsız ilişkinin araştırılmasında kullanıldı. Bulgular: Lezyonların şiddet skoru sınıf IIB1'de 46±18 puan, sınıf IIB2'de 36±20 puan ve sınıf IIIB2'de 53±18 puandı. Sınıf IIB2 ve IIIB2 arasında anlamlı fark vardı (p=0.017). Plazma CRP değerleri ise sırasıyla, 6.6 mg/L, 3.8 mg/L ve 4.8 mg/L bulundu (p=0.371). Difüzyon skoru 4 olan hastaların CRP değerleri difüzyon skoru 1 olan hastalara göre anlamlı olarak yüksek bulundu (11.1 mg/L'ye karşı 3.1mg/L, p=0.048). Tüm çalışma grubu için uygulanan bölümsel korelasyon analizinde, yaş, cinsiyet ve sigaraya göre düzeltme yapıldıktan sonra, CRP değerleri ile koroner lezyonların şiddeti ve yaygınlığı arasında direkt, orta derecede güçlü ve anlamlı bağıntı saptandı, sırasıyla (r=0.30; p=0.034 ve r=0.31; p=0.030). C-reaktif protein ve kararsız anjina pektoris arasında olabilecek bağımsız bir ilişkiyi değerlendirmek için çoklu lojistik regresyon analizi uygulandı, fakat anlamlı bir ilişki saptanmadı (OR: 1.63, %95 GA: 0.90-5.63, p=0.093). Sonuç: Kararsız anjina pektoris kliniğinden bağımsız olarak hastalarımızda CRP düzeyleri ile koroner arter lezyonlarının şiddeti ve yaygınlığı arasında ilişki bulunsa da, CRP ile kararsız anjina klinik şiddeti arasında bağımsız bir ilişki saptanmadı. (Anadolu Kardiyol Derg 2010; 10: 421-8) Anahtar kelimeler: Kararsız anjina, C-reaktif protein, anjiyografi, lojistik regresyon analizi ABSTRACTObjective: We aimed to assess the relationship between C-reactive protein (CRP) and the severity and diffusion of coronary artery lesions in patients with unstable angina pectoris (UAP) and the independent association of CRP with this clinical situation. Methods: This cross-sectional, observational study included 50 patients. Classification by Braunwald was used for UAP. The severity and diffusion of angiographic coronary disease were graded according to Reardon's modified scoring system. Plasma CRP levels were quantified by immunoturbidimetry. Nonparametric tests were used for comparison of CRP and other risk factors, and logistic regression analysis for evaluation of independent association between CR...

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Relationship of C-reactive protein to presence and severity of coronary atherosclerosis in patients with stable angina pectoris or a pathological exercise test

Abstract: CRP level is not related to the extent or the presence of coronary atherosclerosis assessed by coronary angiography, history of myocardial infarction or class of stable angina pectoris in patients referred for coronary angiography for stable angina pectoris or a pathological exercise test.

Cited by 33 publications

References 24 publications

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Association Between Serum C‐reactive Protein Elevation and Atrial Fibrillation After First Anterior Myocardial Infarction

C-reactive protein in unstable angina pectoris and its relation to coronary angiographic severity and diffusion scores of coronary lesions

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