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C-reactive protein and vulnerability to mental stress-induced myocardial ischemia

Rahman Shah1, Matthew M Burg, Aseem Vashist

  • 1Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT 06520-8017, USA.

Molecular Medicine (Cambridge, Mass.)
|March 24, 2007
PubMed

Insights

Elevated C-reactive protein (CRP) levels are associated with a higher risk of mental stress-induced myocardial ischemia (MSI) in patients with coronary artery disease (CAD). This finding suggests CRP may serve as a risk marker for MSI events.

Area of Science:

  • Cardiology
  • Clinical Research
  • Biomarkers

Background:

  • Mental stress-induced myocardial ischemia (MSI) in stable coronary artery disease (CAD) patients predicts adverse clinical outcomes.
  • The underlying mechanisms linking MSI to poor prognosis are not fully understood.
  • C-reactive protein (CRP) is a known cardiovascular risk marker, but its association with MSI is unclear.

Purpose of the Study:

  • To investigate the relationship between serum C-reactive protein (CRP) levels and the risk of developing mental stress-induced myocardial ischemia (MSI) in patients with stable coronary artery disease (CAD).

Main Methods:

  • Eighty-three stable CAD patients underwent simultaneous myocardial perfusion imaging (MPI) using SPECT and transthoracic echocardiography (TTE) at rest and during laboratory-induced mental stress (MS).
  • Serum CRP levels were measured 24 hours post-MS.
  • MSI was diagnosed by new perfusion defects on SPECT and/or new regional wall motion abnormalities on TTE during MS.

Main Results:

  • 36% of patients (30/83) developed MSI.
  • No significant differences were observed in baseline characteristics or hemodynamic responses between patients with and without MSI.
  • Each 1 mg/L increase in CRP level was associated with a 20% increased risk of MSI (OR 1.2, 95% CI 1.01-1.39, P=.04), a finding consistent in multivariate analyses.

Conclusions:

  • Serum CRP levels may serve as a predictive risk marker for mental stress-induced myocardial ischemia (MSI) in patients with coronary artery disease (CAD).
  • Further research is warranted to elucidate the pathophysiological link between CRP and MSI.

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