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The effect of aspirin on C-reactive protein as a marker of risk in unstable angina

S Kennon1, C P Price, P G Mills

  • 1Department of Cardiology, Bart's and the London NHS Trust, United Kingdom. srok@dircon.co.uk

Journal of the American College of Cardiology
|April 13, 2001
PubMed

Insights

Aspirin pretreatment alters the predictive value of C-reactive protein (CRP) for cardiac events in unstable angina. This interaction suggests aspirin modifies inflammatory responses to myocardial injury, impacting event prediction.

Area of Science:

  • Cardiology
  • Inflammation Research
  • Pharmacology

Background:

  • C-reactive protein (CRP) elevation in acute coronary syndromes may indicate myocardial necrosis or inflammation driving atherosclerosis.
  • Aspirin's anti-inflammatory properties or reduction of myocardial necrosis could influence CRP release.
  • The clinical significance of aspirin's effect on CRP in unstable angina requires investigation.

Purpose of the Study:

  • To assess the interaction between aspirin and C-reactive protein (CRP) release in patients with unstable angina.
  • To determine if aspirin pretreatment modifies the prognostic value of CRP for adverse cardiac events.

Main Methods:

  • Prospective cohort study of 304 patients with non-ST-elevation acute coronary syndromes.
  • Serial blood sampling for C-reactive protein (CRP) and troponin I assays.
  • 12-month follow-up for cardiac death and nonfatal myocardial infarction.

Main Results:

  • Patients on aspirin showed lower troponin I concentrations.
  • Maximum CRP concentrations were lower in patients taking aspirin, though not significantly.
  • Significant interaction found: aspirin pretreatment attenuated the predictive value of CRP for 12-month cardiac events.

Conclusions:

  • Prior aspirin therapy significantly influences the association between CRP levels and cardiac events in unstable angina.
  • Aspirin's effect on the acute-phase inflammatory response to myocardial injury is a key mechanism behind this interaction.
Abstract

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