Abstract
Inflammation plays a key role in the pathogenesis of atherosclerosis. This study aimed to assess the relationship of serum inflammatory marker high sensitivity C Reactive protein (hsCRP), with the presence and severity of angiographically evaluated coronary artery disease (CAD). This study was conducted at departments of physiology and cardiology, College of Medicine & King Khalid University Hospital, King Saud University, Riyadh from August 2009 to March 2012. Eighty seven patients (57 males and 30 females) with angiographically evaluated CAD were studied. In all these patients CAD severity was assessed by Gensini scoring and vessel scoring. Control group consisted of 29 healthy subjects (17 males and 12 females). Fasting venous blood samples were analyzed for lipid profile and high sensitivity C-reactive protein (hsCRP). There were non-significant differences in age, weight and BMI among healthy subjects and CAD patients. Comparison of lipid profile between control and CAD patients showed that CAD patients had significantly higher TG and significantly lower HDL levels compared to control subjects. CAD patients presented with significantly higherhsCRP levels than controls. Linear regression analysis between hsCRP and CAD severity determined by Gensini scores showed a significant positive correlation (r=0.423, p=0.018). Triple vessel disease patients had significantly higher hsCRP levels than one vessel and two vessel disease, while the difference was non significant between one and two vessel disease groups. These results suggest that patients with angiographically evaluated CAD have significantly higher levels of hsCRP levels compared to healthy individuals and are correlated with the presence & severity of CAD.
Highlights
There is strong evidence that cardiovascular conditions are linked with inflammation
Data is expressed as Mean ± SD Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) Differences were studied by Mann–Whitney U test for high sensitivity C Reactive protein (hsCRP) and Student’s t test for other parameters
coronary artery disease (CAD) patients presented with higher hsCRP levels but there was no significant correlation of CAD severity with hsCRP or blood lipids
Summary
There is strong evidence that cardiovascular conditions are linked with inflammation. Likewise there is role of inflammation in the pathogenesis of atherosclerosis.[1] This leads to the occurrence of acute cardiovascular events.[2] The chronic inflammatory process in atherosclerosis usually results in an acute clinical event by plaque rupture and causes acute coronary syndromes.[3] Many large prospective trials have shown that the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) is an independent predictor of future cardiovascular events.[4] Several studies from Europe and United States indicate that elevated levels of hsCRP among apparently healthy men and women are a strong predictor of future cardiovascular events.[5,6] Addition of hsCRP to conventional risk factors acts as an independent significant predictor of cardiometabolic risk.[7] hsCRP has been reported to be an independent significant predictor and a risk factor of cardiometabolic risk, with an additive value to metabolic syndrome components.[8] It has a long-term predictive value in patients with diagnosed coronary artery disease (CAD) and angina pectoris.[9,10] It is useful as predictor in individuals with multiple risk factors.[11] hsCRP is an important predictor of first myocardial infarction and for recurrent coronary events.[12,13,14] In most of the studies reported, the association of hsCRP with cardiovascular risk has been found to be highly significant in global risk-assessment programs.[15] Little data is available regarding association of hsCRP with the presence and severity of CAD. To the best of our knowledge there are no studies correlating hsCRP levels in CAD with Gensini and vessel scoring of CAD severity
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