High-sensitive C-reactive protein in patients with coronary artery disease

Virendra C Patil, Aniket B Avhad, Akshay R Kulkarni, Kaustubh A Pandere
Department of Medicine, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India.
DOI: 10.4103/jnsbm.JNSBM_159_19


Background: Inflammation plays a key role in the pathogenesis of atherosclerosis and coronary artery disease (CAD). Aim and Objectives: The aim of this study was to assess the relation of serum high-sensitivity C-reactive protein (hs-CRP) with the presence and severity of CAD. Study Design: This was a cross-sectional, observational study done on patients with diagnosis of acute coronary syndrome (ACS) undergoing coronary angiogram (CAG). Materials and Methods: A total of 100 patients were included in this study satisfying the inclusion criteria. The inclusion criteria were patients with the diagnosis of ACS undergoing CAG. All enrolled patients underwent hs-CRP, hemoglobin, serum creatinine, fasting lipid profile, blood sugar level, resting 12-lead electrocardiogram, creatine kinase–myocardial band, troponin -I, and CAG. Statistical Analysis: Data were analyzed for mean, percentage, standard deviation and Chi-square test for quantitative data using SPSS software version 21 (trial version), and P < 0.05 was considered statistically significant. Results: A total of 63% of male and 37% of female patients underwent CAG. The mean level of hs-CRP was 2.73 (±0.73) mg/L. The level of hs-CRP, severity of coronary artery involvement, and CAD risk factors was significantly more with an hs-CRP level of 1–3 mg/L followed by >3 mg/L. The significant number of patients with double-vessel disease (DVD) and triple-vessel disease (TVD) had an hs-CRP level between 1 and 3 mg/L compared to single-vessel disease (SVD) with P < 0.03. About 67.57% of females and 44.44% of males had an hs-CRP level of 1–3 mg/L, respectively (P < 0.02). A total of 53% of population had an hs-CRP level between 1 and 3 mg/L, 23% had <1 mg/L, and 24% had >3 mg/L (P < 0.02). The hs-CRP was positively correlated with severity of CAD by angiogram (+0.21). Conclusions: A significant number of patients had an hs-CRP level of 1–3 mg/L. The severity of CAD was positively correlated with a level of hs-CRP in incremental fashion. Patients with DVD and TVD had a high hs-CRP level compared to SVD. The hs-CRP can be considered as novel CAD risk factors to be screened in the patients with CAD where it cannot be forecasted by traditional risk factors.

Keywords: Coronary angiogram, coronary artery disease, double-vessel disease, high-sensitivity C-reactive protein, single-vessel disease, triple-vessel disease.

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