Clinical and prognostic significance of C-reactive protein in the conditions of stable angina pectoris in combination with chronic obstructive pulmonary disease stage II–III

Abstract

The aim of the study: to evaluate the clinical and prognostic value of the altered C-reactive protein expression level in functional class II–III stable angina pectoris combined with chronic obstructive pulmonary disease (COPD) stage II–III. Materials and methods. In accordance with the goal of the study, 122 individuals were examined being assigned to 4 clinical groups: Group 1 – 30 patients with ischemic heart disease (IHD, functional class II–III stable angina pectoris, mean age 56.93 ± 1.25 years; male / female ratio 86.67 % / 13.33 %); Group 2 – 30 patients with COPD stage II–III (mean age 57.99 ± 1.12 years; male / female ratio 80.0 % / 20.0%); Group 3 – 40 patients with IHD + COPD (mean age 56.48 ± 1.16 years; male / female ratio 76.92 / 23.08 %) and Group 4 – 22 apparently healthy individuals (mean age 54.37 ± 1.84 years old, male / female ratio 77.50 % / 22.50 %). Results. Significant correlations have been found between the level of C-reactive protein (CRP) and troponin I (r = +0.71 and r = +0.82, p < 0.01 for both pairs) in IHD and IHD + COPD groups. When the level of CRP expression was elevated, a clear increase in the level of cardiospecific proteins (troponin I) was seen, which could indicate a damage to the myocardium. A positive association was found between the CRP level and the CAT scale score in COPD and IHD+COPD groups (r = +0.65 and r = +0.73, respectively, p < 0.05) indicating a significant association between the processes of systemic inflammation and the dynamics of a patient’s subjective condition, caused mainly by the severity of ventilatory and respiratory disorders and pulmonary obstruction. The relative risk for cardiorespiratory fitness impairment (according to 6MWD) in patients with a high level of CRP (>6 mg/L) was almost 13 times higher (EER 80.0 % CER 6.25 %, RR = 12.8 at 95 % CI, which was 1.87–87.56, р < 0.001), while the odds ratio was 60 (OR = 60.0 with CI 4.69–767.85, р < 0.001), compared to patients with a CRP level <6 mg/L, indicating systemic inflammatory process progression in the development of a negative prognosis of IHD combined with COPD. Conclusions. The study and examination of the CRP level is necessary as a prognostic predictor for assessing the risk for developing cardiovascular complications in ІHD combined with COPD.