C-reactive protein elevation and disease activity in patients with coronary artery disease
Ramón Arroyo-Espliguero1, Pablo Avanzas, Juan Cosín-Sales
1Coronary Artery Disease Research Unit, Department of Cardiological Sciences, St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
Insights
C-reactive protein (CRP) levels predict future cardiovascular events independently of coronary artery disease (CAD) severity. Higher CRP levels also correlate with complex coronary artery stenosis, indicating plaque vulnerability.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Coronary artery disease (CAD) poses a significant risk for cardiovascular events.
- Inflammatory markers, such as C-reactive protein (CRP), are increasingly recognized for their role in cardiovascular pathology.
Purpose of the Study:
- To determine if CRP is an independent predictor of cardiovascular events.
- To assess the correlation between CRP levels and the complexity of coronary artery stenosis.
Main Methods:
- Study included 825 angina patients (700 with chronic stable angina, 125 with acute coronary syndromes).
- One-year follow-up assessed composite endpoints including myocardial infarction, unstable angina, and cardiac death.
- High-sensitivity CRP (Hs-CRP) levels were measured and correlated with angiographic findings and clinical status.
Main Results:
- Hs-CRP was higher in patients who experienced cardiovascular events (P=0.03).
- Hs-CRP levels were significantly higher in patients with acute coronary syndromes compared to chronic stable angina (P=0.004).
- Hs-CRP correlated with the number of complex coronary artery stenoses (r=0.36, P=0.01) and NYHA functional class (p<0.0001).
Conclusions:
- CRP levels independently predict future cardiovascular events, irrespective of CAD severity.
- CRP levels correlate with the complexity of coronary artery stenosis, suggesting a role in atheromatous plaque vulnerability.
- CRP serves as a valuable biomarker for assessing CAD activity and cardiovascular risk.
Aims:
We sought to assess (1) whether C-reactive protein (CRP) is an independent predictor of future cardiovascular events after adjustment for coronary artery disease (CAD) severity and (2) whether CRP levels correlate with number of angiographically complex coronary artery stenosis.
Methods And Results:
We studied 825 consecutive angina patients (mean age 63+/-10 years, 74% men), 700 with chronic stable angina (CSA) and 125 with acute coronary syndromes without ST-segment elevation (ACS). The composite endpoint of non-fatal acute myocardial infarction, hospital admission with class IIIb unstable angina and cardiac death was assessed at one year follow-up. Hs-CRP level was higher in CSA patients with the combined end-point (P=0.03) after adjustment for number of diseased coronary arteries. Hs-CRP was also significantly higher in patients with ACS compared to CSA ( P=0.004) and correlated with number of complex angiographic stenoses (r=0.36, P=0.01). Hs-CRP was also increased in patients with NYHA functional class III or IV compared to those in class I or II (p<0.0001).
Conclusions:
CRP levels predict future cardiovascular events independently of CAD severity and correlate with number of angiographically complex coronary artery stenosis in patients with ACS. Thus, CRP levels are a marker of atheromatous plaque vulnerability and CAD activity.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies