Serum hs-CRP Levels In Patients Research Articles

Fasting Serum Lipid Profile and Its Association with Serum High Sensitivity C-Reactive Protein in Type II Diabetes Mellitus

Background: Patients with type II diabetes mellitus frequently have altered lipid profiles. Detection of serum high sensitivity C-reactive protein is associated with cardiovascular events in type II DM as the presence of subclinical inflammation. The study was undertaken to observe the fasting serum lipid profile level and its association with serum hs-CRP in type II DM.
 Materials and methods: A hospital-based observational study was carried out in the Outpatient Department of Endocrinology, Chittagong Medical College Hospital and Department of Biochemistry, Chittagong Medical College. By using non-probability consecutive sampling, a total of 176 participants were enrolled, with 126 type II DM and 50 in the control group. Plasma glucose and serum hs-CRP, fasting serum lipid profile was estimated.
 Results: The mean serum hs-CRP level in patients with type II DM (9.1 ± 0.36 mg/L) was significantly (p 0.0001) elevated as compared to control (4.3 ± 0.09 mg/L). The result showed an increase in serum total cholesterol, serum triglycerides, serum HDLC and serum LDL-C among the diabetic patients when compared with the healthy control group. Serum hs-CRP was significantly associated with serum TG and serum LDL-C in type II diabetics. Moreover, serum hs-CRP was found to have a significant positive correlation with serum LDL-C and serum TG. Only 77.78% of patients had increased LDL-C but altogether 85.71% of patients had increased serum hs-CRP levels.
 Conclusion: According to the findings of this study,increased serum hs-CRP was well associated and positively correlated with components of the fasting lipid profile, indicating early identification of cardiovascular risk among type II diabetics.
 Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 35-39

English

BACKGROUND Relationship between serum uric acid and cardiovascular system has been recognised since years. High-sensitivity C-reactive protein (hs-CRP) is a known risk factor for cardiovascular and cerebrovascular events. The role of uric acid as a risk factor for vascular disease and acute stroke is controversial and there is little information about it.1 It is unclear as to whether high uric acid concentrations promote or protect against the development of cerebrovascular disease, or simply acts as a passive marker of increased risk. As serum hs-CRP is an established risk factor for stroke, its positive correlation with serum uric acid levels would suggest that high serum uric acid could predict stroke risk. Also, it would prove to be a more cost-effective investigative tool in our present set up. METHODS In this cross-sectional study, we assessed 100 patients admitted with acute stroke in Victoria and Bowring and Lady Curzon Hospital from October 2016 to November 2018. Clinical records, routine investigations, radiological imaging, serum uric acid and hs-CRP of the patients were investigated. RESULTS Majority of the patients (33 %) belonged to the age group of > 70 yrs., followed by 61 - 70 yrs. (26 %). 69 % of the patients were males and 31 % were females. 67 % of them were hypertensive and 32 % were diabetic. 91 % had an hs-CRP level of > 3.0 mg / L and 8 % had hs-CRP levels between 1.0 and 3.0 mg / L. None of the female patients had a serum uric acid value > 6.5 mg / dL and none of the male patients had a uric acid level of > 7.0 mg / dL. There was a correlation between serum uric acid levels and serum hs-CRP levels in patients ≤ 50 yrs. of age. There was no correlation between serum hs-CRP levels and serum uric acid levels in patients more than 50 yrs. of age. CONCLUSIONS Our study showed that stroke is most common in persons > 70 yrs. of age and is more common in males compared to females. Hypertension is an independent risk factor for stroke. hs-CRP is a well-established risk marker for stroke, being raised in majority of stroke patients. Serum uric acid is not raised in all patients of acute stroke. So, it cannot be used as a risk marker for stroke. KEY WORDS hs-CRP, Serum Uric Acid, Acute Stroke

Effect of Coenzyme Q10 Supplementation on Serum of High Sensitivity c-reactive Protein Level in Patients with Cardiovascular Diseases: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Possible effects of coenzyme Q10 (CoQ10) supplement on the serum level of high-sensitivity C-reactive protein (hs-CRP) in cardiovascular diseases (CVDs) remains unclear.Objective:Therefore, this meta-analysis was conducted to investigate its effects on the serum hs-CRP level in patients with CVDs. A comprehensive search was conducted on the EMBASE, MEDLINE, and PubMed Central databases for pertinent papers in English up to November 2016. All randomized controlled trials (RCTs) that studied the effects of supplementation with CoQ10 on the serum of hs-CRP level in cardiovascular patients were included. We used random-effects models (the DerSimonian–Laird method) to estimate the pooled effect of selected studies and the I2 test to assess the between-study heterogeneity. The subgroup analyses were carried out according to the baseline serum hs-CRP, quality assessment score, supplementation dosage, and duration of intervention. Of 205 studies, five trials were eligible for inclusion in this study with 159 participants in the ntervention and 143 participants in the placebo group. Results of the pooled analysis revealed that the CoQ10 supplementation had no significant effect on the serum level of hs-CRP compared with the placebo group (MD: 0.120; 95% = −0.944, 1.185; P = 0.825). Moreover, the subgroup analyses showed the baseline serum hs-CRP, quality assessment score, and duration of intervention can be sources of heterogeneity. The results of this study demonstrated that the beneficial effect of CoQ10 supplementation for patients with CVDs is observed in those who received this supplement for more than 12 weeks and with the baseline serum hs-CRP >3 mg/L.

Associations of cigarette smoking, betel quid chewing and alcohol consumption with high-sensitivity C-reactive protein in early radiographic knee osteoarthritis: a cross-sectional study

ObjectivesHigh-sensitivity C-reactive protein (hsCRP) is possibly related to osteoarthritis (OA) progression and a variety of OA-related symptoms. This study aimed to examine associations between cigarette smoking, betel quid chewing and...

Abstract 12851: Clinical Significance of Myeloperoxidase, Neopterin, and High Sensitivity C-Reactive Protein as Independent Predictors of Cardiovascular Events

Background: We previously demonstrated that inflammatory biomarkers such as myeloperoxidase (MPO), a member of the heme peroxidase superfamily, and neopterin (produced by activated macrophages after interferon-γ stimulation by T-lymphocytes) are important in the pathogenesis of coronary plaque instability. Additional evidence supports high sensitivity C-reactive protein (hs-CRP) as an independent predictor of increased coronary risk. We assessed the prognostic significance of plasma MPO and neopterin levels, and serum hs-CRP levels in patients with stable angina pectoris (SAP) and unstable angina pectoris (UAP). Methods: Plasma MPO, neopterin, and serum hs-CRP levels were measured in 219 SAP patients and 144 UAP patients at admission. Cardiovascular (CV) events were defined as sudden cardiac death, fatal or non-fatal myocardial infarction and other non-fatal events including unstable angina pectoris or coronary revascularization. Results: Over a mean follow-up of 27±14 months, 56 SAP patients (26%) had CV events. When SAP patients were stratified based on the median neopterin level (15.0 nmol/L), Kaplan-Meier analysis showed that the high-neopterin group (>15.0 nmol/L) had significantly worse outcomes (P=0.015) than the low-neopterin group. Multivariate analysis showed that elevated neopterin was the only independent factor associated with CV events (OR, 2.19; 95% CI, 1.18-4.09; P=0.014). In contrast, over a mean follow-up of 30±24 months, 33 UAP patients (23%) had CV events. When UAP patients were divided based on the median MPO level (16.0 ng/mL), Kaplan-Meier analysis showed that the high-MPO group (>16.0 ng/mL) had significantly worse outcomes (P=0.012) than the low-MPO group. Multivariate analysis showed that elevated MPO was the only independent factor associated with CV events (OR, 2.58; 95% CI, 1.07-6.23; P=0.035). With regard to hs-CRP levels, there were no significant differences in CV events between the two groups according to the median hs-CRP in both SAP and UAP patients. Conclusions: The clinical significance of elevated MPO and neopterin levels as independent predictors of CV events differs depending on the clinical condition of SAP and UAP patients, because of different production mechanisms of these biomarkers.

Serum hs-CRP Levels are Increased in de Novo Parkinson's Disease Independently from Age of Onset

Background: Microglia in the brain are the counterpart of macrophages and it functions as a first defense in the brain. The double-edged feature of microglia has explained that the inflammatory state of microglia in aged brains induces them to over-respond to small stimuli that are otherwise well controlled in young brains. The clinical effect of microglia in patients with Parkinson's disease (PD) is poorly defined. This prospective study assessed the peripheral concentrations of hs-CRP, a protein able to reflect neuroinflammation in the CNS, in de novo PD patients with varying ages of onset. Methods: We examined 435 patients with de novo PD and 221 healthy subjects and the differences in hs-CRP between these groups were investigated. The PD group was classified into 4 subgroups according to the age of de novo PD to investigate the relationship between hs-CRP and the aging process in de novo PD. Results: There were significantly higher serum hs-CRP levels in patients with PD compared with healthy subjects. A post-hoc analysis of the 4 PD subgroups showed no significant differences in serum hs-CRP level. Conclusion: We assumed that neuroinflammatory reactions play a role in the pathogenesis of PD, but found no clinical evidence of a neuroprotective effect against PD in young brains. To clarify the role of microglia and aging in the pathogenesis of PD, future longitudinal studies involving a large cohort are required.

Elevated resistin levels are associated with inflammation in hemodialysis patients with failed renal allografts.

Resistin is an adipocytokine, associated with insulin resistance and inflammation. The aim of this study is to evaluate the levels of serum resistin levels and other markers of inflammation in hemodialysis (HD) patients with failed renal allografts. Sixty-nine HD patients with failed renal allografts and 98 never transplanted (naive) HD patients and also 21 healthy controls were included in the study. Serum levels of various biochemical parameters as well as resistin, IL-6, TNF-α and hs-CRP as biochemical markers of inflammation, were measured. Serum resistin levels in patients with failed renal allografts (4.80 ± 2.06 ng/mL) were significantly higher than those of the naive HD patients (3.44 ± 1.48 ng/mL) and healthy controls (0.95 ± 0.38 ng/mL; p<0.001). Patients with failed transplants were also characterized by higher TNF-alpha levels (96.8 ± 131.3 pg/mL vs. 40.9 ± 25.4 pg/mL; p<0.001) and IL-6 levels (83.9 ± 150.9 pg/mL vs. 14.6 ± 14.4 pg/mL; p<0.001) as compared to naive HD patients. Serum hs-CRP levels in patients with failed renal allografts (9.33 ± 11.86 mg/L) were significantly higher than those of the naive HD patients (1.26 ± 1.71 mg/L) and healthy controls (2.12 ± 1.82 mg/L; p<0.001). Serum albumin levels in patients with failed transplants (3.84 ± 0.47 g/dL) were lower as compared to never transplanted HD patients (4.13 ± 0.33 g/dL) and healthy controls (4.53 ± 0.40 g/dL; p<0.001). There was a positive correlation between serum resistin and TNF-alpha levels (r = 0.486, p<0.001). Serum resistin levels are increased in HD patients with failed renal allografts very probably reflecting an allograft-induced chronic inflammatory state.

Serum High-Sensitivity C-Reactive Protein Levels and Response to 5 mg Tadalafil Once Daily in Patients With Erectile Dysfunction and Diabetes

PurposeWe studied the relative importance of high-sensitivity C-reactive protein (hs-CRP) concentrations in patients with erectile dysfunction (ED) and diabetes and determined whether the hs-CRP level predicts the response to treatment with 5 mg tadalafil once daily.Materials and MethodsWe enrolled 102 men (aged 40-60 years) with diabetes and ED. All patients completed the International Index of Erectile Function (IIEF) questionnaire and were given 5 mg tadalafil daily. The IIEF and serum hs-CRP levels in patients and healthy controls and in patient responders and nonresponders to 5 mg tadalafil once daily were compared.ResultsMedian age was 53.2 years (range, 45 to 62 years) in patients and 55.6 years (range, 47 to 64 years) in healthy controls (p=0.158). The median duration of diabetes was 54.3 months (range, 34 to 70 months). The median IIEF and hs-CRP level were 12.1 (range, 5 to 20) and 0.21 mg/dL (range, 0.05 to 0.6 mg/dL) in patients and 28.2 (range, 13 to 31) and 0.09 mg/dL (range, 0.04 to 0.2 mg/dL) in the controls, respectively (pIIEF=0.000, pCRP=0.031). After tadalafil treatment, 71 patients (69.6%) achieved an erection sufficient for sexual intercourse, whereas 31 (30.4%) did not. The median age of the tadalafil nonresponders was 56.2 years (range, 45 to 64 years) and that of the responders was 51.3 years (range, 42 to 62 years; p=0.065). Median hs-CRP levels were 0.31 mg/dL (range, 0.18 to 0.62 mg/dL) in nonresponders and 0.14 mg/dL (range, 0.09 to 0.4 mg/dL) in responders, respectively (p=0.028).ConclusionsSerum hs-CRP was significantly higher in patients with ED and diabetes mellitus than in patients without ED. A significant correlation was observed between serum hs-CRP levels, the degree of ED, and responsiveness to tadalafil.

The effect of hepatitis B virus on the expression of high sensitive C-reaction protein and its clinicalimplication

Objective To explore the effect of hepatitis B virus （HBV） on the expression of high sensitive C-reaction protein（hs-CRP） and its clinical implication. Methods mRNA expression of hs-CRP in HepG2 and HepG2.2.15 cells was measured by RT-PCR, serum hs-CRP levels in patients with HBV infection and in healthy individuals were measured by biochemical analyzer Olympus5400, the expression of hs-CRP difference among patients with chronic hepatitis B, liver cirrhosis and hepatocellular carcinoma were analyzed. Results Expression of hs-CRP mRNA was higher in HepG2.2.15 ceils than in HepG2 cells, serum hs-CRP levels was much higher in HBV patients as compared to healthy individuals （ P〈0.05 ） , hs-CRP was detected at higher levels in patients with liver cirrhosis or hepatocellular carcinoma than those with chronic hepatitis B. Conclusion HBV can upregulated the expression of hs-CRP, which is associated with the disease progression. Key words: Hepatitis B virus; High sensitive C-reaction protein; Liver cirrhosis; Hepatocellularcarcinoma

The relationship betweenhighly sensitive C-reactive protein and acute cerebrovascular disease

：Objective To investigatethe changes of the serum level of highly sensitive C-reactive protein (hs-CRP)in patientswith cerebrovascular disease and its clinical significance. Methods The serum level ofhs-CRP in 60 patients with acute cerebral infarction and 60 patients with acute cerebralhemorrhage and 40 healthy persons were determined.All the patients were scored by clinicneurological deficit scale(NDS),and were compared in groups. Results The serum level ofhs-CRP in patients with acute cerebral infarction and with acute cerebral hemorrhage weresignificantly higher than that in normal controls(t=19.712 13.217 P <0.01).There was noobvious difference between the patients with acute cerebral infarction and with acutecerebral hemorrhage. Conclusion The serum level of hs-CRP was closely correlated with theseverity of cerebrovascular disease.

The clinical study about the relationship between acute cerebral infarction and carotid atherosclerosis,C-reactive protein

Objective To investigate the relationship between carotid atherosclerosis,high-sensity C-reactive protein(hs-CRP)and acute cerebral infarction.Methods Histological changes of carotid artery were observed by color Doppler and the serum CRP were evaluated in 86 patients with acute cerebral infarction,compared with the con-trol group which contained 88 non-cerebral infarction patients.Results Incidence of carotid artery endothelial plaque in patients with acute cerebral infarction was significantly higher than those of control group(P<0.01).In patients with acute cerebral infarction,soft plaque and mixed plaque were predominant while hard plaque were predominant in control group,there were significant differences between the two groups(P<0.01).Serum hs-CRP level in patients with cerebral infarction was obviously higher than those of control group(P<0.01).Serum CRP levels in 5 groups were respectivdy(9.81±2.42)ms/L,(10.05±2.55)ms/L,(9.45±2.53)ms/L,(6.16 ±1.7)mg/L and(6.40±1.95)mg/L,which histological changes of carotid artery endothelial were soft plaque,mixed plaque,hard plaque,crude endothelium and normal,the levels of serum CRP in soft plaque group and mixed plaque group were higher than those of hard plaque group,crude endothelium group and nomal group(P<0.01).Conclusions Incidence of carotid artery endothelial plaque and serum CRP levels were obviously increased in patients with acute cerebral infarction.In-crease of the serum CRP levels can represent the properties and stability of carotid artery plaque. Key words: Brain Infarction; Atherosclerosis; Carotid arteries; C-reactive protein

Association of Periodontal Parameters With Metabolic Level and Systemic Inflammatory Markers in Patients With Type 2 Diabetes

Although worldwide evidence tends to prove that diabetes adversely affects periodontal health, there are insufficient clues indicating whether periodontitis may aggravate metabolic control and systemic inflammation. This study, as a preliminary part of an ongoing research project, aims to clarify the relationship of periodontal parameters with metabolic levels and systemic inflammatory markers in patients with diabetes. A total of 140 qualified, adult patients with type 2 diabetes and periodontitis were recruited into this study. Periodontal examinations, including a full-mouth assessment of probing depths (PDs), bleeding on probing, gingival recession, and clinical attachment level, were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting glucose, high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-alpha), and lipid profiles. Subjects were divided into three groups according to tertiles of the mean PD and compared. Upon an analysis of covariance, subjects with an increased mean PD had significantly higher levels of HbA1c and hsCRP (P <0.05). No significant difference was found among different groups in the levels of serum TNF-alpha, fasting glucose, and lipid profiles (P >0.05). After controlling for age, gender, body mass index, duration of diabetes mellitus, smoking, regular physical exercise, and alcohol consumption, positive correlations were found between mean PD and HbA1c (r = 0.2272; P = 0.009) and between mean PD and hsCRP (r = 0.2336; P = 0.007). After adjustment for possible confounders, the mean PD emerged as a significant predictor variable for elevated levels of HbA1c and hsCRP (P <0.05). Chronic periodontitis was associated with glycemic metabolic and serum hsCRP levels in patients with type 2 diabetes.

High‐sensitivity C‐reactive protein in chronic low back pain with vertebral end‐plate modic signal changes

To assess high-sensitivity C-reactive protein (hsCRP) level as a measure of low-grade inflammation in relation to Modic vertebral end-plate marrow signal change on magnetic resonance imaging (MRI) in patients with chronic low back pain. All patients hospitalized for chronic low back pain in our institution were prospectively enrolled in this pilot study. Serum hsCRP concentration was measured by immunoturbidimetric assay. MR images were evaluated independently by a panel of 2 spine specialists and a radiologist. Recording of clinical parameters, MRI evaluation, and hsCRP level of each patient was blinded. Three groups of 12 consecutive patients (Modic 0, Modic I, and Modic II signal changes on MRI) were prospectively selected. Serum hsCRP level was significantly different in the 3 groups (P = 0.002) and especially high in the Modic I group (P = 0.002 compared with Modic 0 and II groups): mean +/- SD 1.33 +/- 0.77 mg/liter in the Modic 0 group, 4.64 +/- 3.09 mg/liter in the Modic I group, and 1.75 +/- 1.30 mg/liter in the Modic II group. The only difference in clinical parameters among the 3 groups (P = 0.001) was that the worst painful moment during the previous 24 hours occurred during the late night and morning for all Modic I patients (P = 0.001 compared with Modic 0 and P = 0.002 compared with Modic II). Low-grade inflammation indicated by high serum hsCRP level in patients with chronic low back pain could point to Modic I signal changes. This result could help physicians predict the patients with Modic I signals to more precisely prescribe the correct imaging procedure and local antiinflammatory treatment in such patients.

Obesity, and not obstructive sleep apnea, is responsible for increased serum hs-CRP levels in patients with sleep-disordered breathing in Delhi

Objective The present study was conducted to evaluate serum levels of high-sensitivity C-reactive protein (hs-CRP) in newly diagnosed patients with obstructive sleep apnea (OSA). Subjects and methods Between April 2005 and March 2006, a total of 231 consecutive adult habitual snorers underwent polysomnography (PSG) in the sleep laboratory. Ninety-seven subjects were found suitable for hs-CRP measurement after application of the following exclusion criteria: patients with diabetes mellitus, hypertension, coronary artery disease, acromegaly, hypothyroidism, chronic renal failure, congestive cardiac failure, or smoking history, patients who were pregnant, on steroid treatment, on hormone replacement therapy, or with chronic use of drugs such as non-steroidal anti-inflammatory drugs, oral anticoagulants and lipid-lowering drugs and patients having undergone upper airway surgery. Patients were classified as apneic [apnea–hypopnea index (AHI) > 5], obese non-apneic [body mass index (BMI) > 25, AHI < 5] and non-obese non-apneic (BMI < 25, AHI < 5). C-reactive protein levels were measured in stored sera by high-sensitivity enzyme immunoassay (Biocheck, Inc. Foster City, CA, USA). After checking normality with the Kolmogorov–Smirnov test and using a square-root transformation, Pearson’s and partial correlation coefficients were calculated for identified risk factors and confounders. A multiple linear regression model was used to identify variables that were independently associated with hs-CRP. Results The mean serum levels of hs-CRP were found to be 0.25 ± 0.23, 0.58 ± 0.55, and 0.51 ± 0.37 mg/dl in non-obese non-apneics ( n = 23), obese non-apneics ( n = 45) and apneics (obese and non-obese, n = 29), respectively. Pearson’s correlation coefficient of hs-CRP with BMI was found to be 0.25 ( p = 0.01), and with AHI 0.16 ( p = 0.12). Partial correlation analysis showed that hs-CRP levels correlated significantly with BMI after adjustment for AHI and age ( r = 0.22, p = 0.03), while correlation with disease severity as assessed by AHI after adjustment for BMI and age was not significant ( r = 0.10, p = 0.33). After stepwise multiple linear regression, only BMI was found to be significantly associated with serum hs-CRP levels (β = 0.02, p = 0.01). Conclusions In this first comprehensive cross-sectional study on Indian subjects, we found that obesity, and not obstructive sleep apnea, is associated with elevated serum levels of hs-CRP. No independent correlation was found between severity of OSA and hs-CRP in the present study.

The Serum High-Sensitive C Reactive Protein and Homocysteine Levels to Evaluate the Prognosis of Acute Ischemic Stroke

Ischemic stroke is one of the most common causes of death worldwide and is most often caused by thrombotic processes. We investigated the changes in hsCRP and homocysteine levels, two of these risk factors, during the acute period of ischemic stroke and evaluated the relationship between these levels and the short-term prognosis. HsCRP and homocysteine levels were measured at the 2nd, 5th, and 10th days in forty patients admitted within second of an ischemic stroke. The clinical status of the patients was simultaneously evaluated with the Scandinavian stroke scale. The results were compared with 40 healthy control subjects whose age and sex were matched with the patients. The mean hsCRP levels of the patients were 9.4 ± 7.0 mg/L on the 2nd day, 11.0 ± 7.4 mg/L on the 5th day, and 9.2 ± 7.0 mg/L on the 10th day. The mean hsCRP level of the control subjects was 1.7 ± 2.9 mg/L. The mean hsCRP levels of the patients on the 2nd, 5th, and 10th days were significantly higher than the control subjects (P < .001). The patients' mean homocysteine levels were 40.6 ± 9.6 μmol/L on the 2nd day, 21.7 ± 11.1 μmol/L on the 5th day, and 20.7 ± 9.2 μmol/L on the 10th day. The mean homocysteine level of the control subjects was 11.2 ± 1.1 μmol/L. The homocysteine levels of the patients were higher than the control subjects at all times (P < .01). In conclusion, patients with stroke have a higher circulating serum hsCRP and homocysteine levels. Short-term unfavorable prognosis seems to be associated with elevated serum hsCRP levels in patients with stroke. Although serum homocysteine was found to be higher, homocysteine seems not related to prognosis.

High sensitivity C-reactive protein in asthma

Asthma is characterised by chronic inflammation of the airways, but the relevance of high-sensitivity assays for C-reactive protein (hs-CRP), which are known to be a sensitive marker of low-grade systemic inflammation, has not been fully studied in asthma. The objective was to examine serum hs-CRP levels in patients with asthma and their relationship to clinical characteristics and degree of airway inflammation. Serum hs-CRP levels were cross-sectionally examined in steroid-naive (n = 22) and steroid-inhaling (n = 23) adult patients with asthma and healthy controls (n = 14). All were nonsmokers. Serum hs-CRP levels were significantly increased in steroid-naive patients (mean+/-sd 1.33+/-1.48 mg.L(-1)) compared with controls (0.21+/-0.30 mg.L(-1)), but not in patients on inhaled corticosteroid. Among steroid-naive patients, serum hs-CRP levels significantly negatively correlated with indices of pulmonary function (forced expiratory volume in one second/forced vital capacity and forced mid-expiratory flow) and positively with sputum eosinophil count. Among patients on inhaled corticosteroid, hs-CRP levels did not correlate with any indices. In conclusion, an increase in serum C-reactive protein levels measured by high-sensitivity assays may be associated with airflow obstruction and airway inflammation, and may serve as a surrogate marker of airway inflammation in asthma.

Elevated Preprocedural High-Sensitivity C-Reactive Protein Levels are Associated With Neointimal Hyperplasia and Restenosis Development After Successful Coronary Artery Stenting

Recent data indicate that an elevated serum level of high-sensitivity C-reactive protein (hs-CRP) predicts the risk of recurrent coronary events, and that statin therapy decreases the risk of coronary events. This study assessed the relationship between the pre-procedural hs-CRP level and in-stent neointimal hyperplasia (NIH) after stenting and the effects of statins on the relationship between restenosis after stenting and the serum hs-CRP levels of patients with coronary artery disease. This study included 100 patients who underwent stent implantation for angiographically significant stenosis. Patients were divided into a normal C-reactive protein (CRP) group (<0.5 mg/dl, n=59) and elevated CRP group (>or=0.5 mg/dl, n=41). All patients underwent angiographic and intravascular ultrasound follow-up at 6 months. The baseline CRP level was 0.29+/-0.08 mg/dl in the normal CRP group and 2.90+/-2.31 mg/dl in the elevated CRP group. The NIH cross-sectional area (CSA) in the minimal lumen CSA at follow-up was significantly larger in the elevated CRP group compared with the normal CRP group (1.9+/-1.3 mm2 vs 3.0+/-1.5 mm2, p=0.001). A significant positive correlation was found between pre-interventional CRP level and NIH area (r=0.52, p<0.001). In patients with normal CRP, an association between statin therapy and restenosis was not observed. However, when the analysis was confined to patients with elevated CRP, statin therapy significantly reduced the restenosis rate (20% vs 37.5%, p=0.031). In the normal CRP group, the intra-stent neointimal area at 6 months was not different between the non-statin and statin groups (2.2+/-1.4 mm2 vs 1.8+/-1.1 mm2). However, in the elevated CRP group, statin therapy significantly decreased the neointimal area at 6-month follow-up (3.6+/-1.7 mm2 vs 2.4+/-1.3 mm2, p<0.001). Measuring the pre-interventional hs-CRP level may help predict the development of restenosis after stenting and statin therapy will significantly reduce the restenosis rate in patients with an elevated hs-CRP.

Levels and Values of Serum High-Sensitivity C-Reactive Protein Within 6 Hours After the Onset of Acute Myocardial Infarction

C-reactive protein (CRP), which has been suggested to directly enhance inflammation in plaques, is rapidly synthesized and secreted in the liver 6 h after an acute inflammatory stimulus. Therefore, serum levels of CRP within 6 h after the onset of acute myocardial infarction (AMI) merely reflect a chronic and persistent inflammatory process and are not due to acute myocardial damage. We hypothesized that the serum CRP level, which would abnormally elevate thereafter, is followed by a plaque rupture in the clinical setting of AMI. CRP was prospectively measured by high-sensitivity CRP assay (hs-CRP) in 157 consecutive patients (106 patients within 6 h, and 51 patients >/= 6 h but < 12 h after the onset of AMI) with ST-segment elevation AMI undergoing primary percutaneous coronary intervention (PCI). Serum levels of hs-CRP were also measured in 30 patients with stable angina undergoing elective PCI and in 30 healthy control subjects. The serum level of hs-CRP was significantly higher in patients with an onset of AMI < 6 h than in patients with angina pectoris (2.7 +/- 2.3 mg/L vs 1.4 +/- 0.7 mg/L, p < 0.0001 [mean +/- SD]) and in healthy subjects (2.7 +/- 2.3 mg/L vs 1.0 +/- 0.6 mg/L, p < 0.0001). There were no significant differences in serum levels of hs-CRP in patients with an onset of AMI </= 3 h than in those patients with an onset of AMI > 3 h but < 6 h (2.7 +/- 2.5 mg/L vs 2.7 +/- 2.2 mg/L, p = 0.87). However, the serum level of hs-CRP was significantly higher in patients with an onset >/= 6 h than in patients with an onset < 6 h (14.1 +/- 16.5 mg/L vs 2.7 +/- 2.3 mg/L, p < 0.0001). Serum levels of hs-CRP were significantly higher in patients with an onset of AMI < 6 h than in healthy subjects and in patients with angina pectoris undergoing PCI. The inflammatory process has been proved as one of the mechanisms causing plaque rupture. Elevated serum hs-CRP levels in patients with AMI < 6 h may portend vulnerable plaque rupture.