The prognostic value of high-sensitive C-reactive protein and cardiac troponin T in young and middle-aged patients with chest pain without ECG changes

Abstract

There is growing evidence concerning the prognostic importance of inflammatory markers in angina pectoris. The independent value of high-sensitivity C-reactive protein (hsCRP), cardiac troponin T (cTnT), or their combination has yet to be determined in young patients with angina pectoris without ECG changes. The 6-month prognostic value of serum hsCRP and cTnT was evaluated in young and middle-aged patients admitted to the hospital with chest pain without ECG changes. Forty young or middle-aged patients (45±10 years old; 2 women, 38 men) with new-onset angina pectoris with no ECG changes or CPK-MB elevation were prospectively evaluated between June 2000 and June 2001. Blood was obtained at admission, separated, and serum was frozen at −80°C for 1 year until thawed and evaluated as 1 batch to measure hsCRP and cTnT levels. Patients were monitored clinically for 6 months. The strongest independent marker of an adverse outcome was the hsCRP level at the time of admission (sensitivity 66.7%; specificity 94.1%); cTnT level added somewhat to specificity (97.1%). It did not add to the sensitivity seen at the hsCRP level. The hsCRP level at admission may be an independent prognostic marker in young and middle-aged patients with angina pectoris without ECG changes and without CPK-MB elevation.