Short-term prognostic value of CRP in the patients with acute coronary syndrome

Abstract

Background and Objectives:Acute coronary syndrome occurs most commonly in the setting of atherosclerotic coronary artery disease, but there is little information concerning the mechanism responsible for the transition from stable to unstable coronary atherosclerotic plaque. Hypothetically, several microorganism (Chlamydia pneumonia, Cytomegalovirus and Helicobacter pylori) and their inflammatory reaction have been suggested as a causative motive in progression of acute coronary syndrome. Although it is unclear whether the serum level of CRP as an inflammatory parameter is concerned with previous inflammatory change or myocardial necrosis, CRP appears to be predictive of higher risk for cardiac event in the patients with acute coronary syndrome. Our objective was to evaluate whether the inflammatory parameters (CRP, ESR and WBC count) are useful in predicting the short-term cardiac risk within 30 days. Materials and Method:One hundred and ten patients with acute coronary syndrome were enrolled from April 1998 through August 1998. Blood samples were collected at 1st hour, 24th hour, 48th hour and 7th day and tested for CRP, ESR, WBC count and CK-MB level. Values of 323 normal were used as control. All patients were followed up for 30 days and assessed for the presence of cardiac complications. Results:Peak CRP value of the patients with acute myocardial infarction (3.4±3.85 mg/dL, n= 62) was higher than that of the patients with unstable angina (0.7±0.93 mg/dL, n=48, p 2 mg/dL, n=30), the cardiac complication rate was higher than the low-CRP group (≤2 mg/dL, n=80)(43.3% vs 2.5%, p<0.05). Peak CRP value was correlated with age (r=0.191, p=0.045), pulse rate (r=0.186, p=0.008), left ventricular ejection fraction (r=-0.384, p<0. 001), peak ESR (r=0.383, p<0.001) and peak WBC count (r=0.307, p=0.001), but not with peak CK-MB level. Conclusion:Elevated CRP level in patients with acute coronary syndrome seems to be a valuable 논문접수일:1999년 8월 16일 심사완료일:2000년 12월 19일 교신저자:채성철, 700-721 대구광역시 중구 삼덕동 2가 50번지 경북대학교병원 순환기내과 전화:(053) 420-5527·전송:(053) 426-2046 E-mail:scchae@knu.ac.kr