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C-reactive protein, prothrombotic imbalance and endothelial dysfunction in acute coronary syndromes without ST

E Apetrei1, Ruxandra Ciobanu-Jurcuţ, Mihaela Rugină

  • 1Institute of Cardiovascular Diseases Prof. dr. C.C. Iliescu, Bucharest, Romania.

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|November 9, 2004
PubMed

Insights

Inflammation, measured by C-reactive protein (CRP), is linked to a prothrombotic state in acute coronary syndromes (ACS). This suggests CRP may be a risk factor, not just a marker, in ACS development.

Area of Science:

  • Cardiology
  • Biochemistry
  • Pathophysiology

Background:

  • Inflammation plays a key role in acute coronary syndromes (ACS) pathogenesis.
  • C-reactive protein (CRP) is a potential biomarker for ACS risk stratification.
  • The role of CRP as a risk marker versus a risk factor in ACS requires further investigation.

Purpose of the Study:

  • To investigate the association between inflammation and prothrombotic factors in patients with ACS without ST elevation.
  • To determine if elevated C-reactive protein (CRP) levels correlate with specific coagulation and fibrinolysis parameters.

Main Methods:

  • Study included 86 patients diagnosed with unstable angina or NSTEMI.
  • Measured CRP, fibrinogen, white blood cell count, and various coagulation factors (V, VIII, vWf, AT III, D-dimers, proteins C and S).
  • Analyzed correlations between CRP quartiles and measured coagulation/fibrinolysis parameters.

Main Results:

  • Higher CRP levels (4th quartile) were associated with increased levels of von Willebrand factor, factor V, and factor VIII.
  • Elevated inflammation correlated with decreased levels of antithrombin III, protein C, and protein S.
  • No significant association was found with PAI-I or D-dimers, possibly due to marker sensitivity limitations.

Conclusions:

  • Inflammation, quantified by CRP, is significantly associated with a prothrombotic state in ACS patients.
  • High CRP levels indicate endothelial dysfunction, as suggested by elevated von Willebrand factor.
  • CRP may serve as a crucial indicator of both inflammation and thrombotic risk in ACS.
Abstract

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