Related Experiment Video
Updated: May 12, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Role of C-reactive protein in determining microvascular function in patients with non-ST-segment elevation acute
Murat Sezer1, Cansu Akdeniz, Emre Aslanger
1Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Capa, Istanbul, Turkey. sezerm@istanbul.edu.tr
Insights
Inflammation, indicated by C-reactive protein (CRP) levels, is linked to coronary microvascular dysfunction in acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI). Higher CRP predicts worse microvascular resistance post-PCI.
Area of Science:
- Cardiology
- Vascular Biology
- Inflammation Research
Background:
- Coronary microvascular dysfunction (CMD) extent may relate to inflammation.
- Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI) are at risk for CMD.
Purpose of the Study:
- To investigate the association between serum C-reactive protein (CRP) levels and CMD.
- To assess CRP's role in baseline and post-PCI CMD in NSTE-ACS patients.
Main Methods:
- 42 NSTE-ACS patients undergoing PCI were studied.
- Coronary microvascular resistance (MR) was measured pre- and post-PCI using Doppler guidewire.
- Serum CRP levels were measured on admission.
Main Results:
- Admission CRP levels correlated significantly with pre-PCI MR (r=0.498), post-PCI MR (r=0.429), and periprocedural MR changes (r=0.785).
- Multivariate analysis identified serum CRP as the sole predictor for pre- and post-PCI MR.
- Serum CRP and angiographic thrombus predicted periprocedural MR changes.
Conclusions:
- Serum CRP levels are associated with increased coronary microvascular resistance in NSTE-ACS patients.
- Inflammatory processes, reflected by CRP, may contribute to microvascular impairment in this patient group.
Abstract:
The extent of coronary microvascular dysfunction might be related, not only to patient characteristics and procedural factors, but also to the inflammatory status. The aim of the present study was to examine a possible association between inflammation, as reflected by the serum C-reactive protein (CRP) levels, and the extent of baseline and post-percutaneous coronary intervention (PCI) coronary microvascular dysfunction in patients with non-ST-segment elevation acute coronary syndrome undergoing PCI. A total of 42 patients undergoing PCI for non-ST-segment elevation acute coronary syndrome were enrolled. Coronary microvascular resistance (MR) was determined in the territory of culprit artery using a Doppler probe- and a pressure sensor-equipped guidewire both before (taking the collateral blood into account) and after PCI. The periprocedural changes in MR were calculated. The CRP levels at admission were correlated with the pre-PCI MR (r = 0.498, p = 0.001), post-PCI MR (r = 0.429, p = 0.005), and periprocedural changes in MR (r = 0.785, p <0.001). On multivariate regression analysis, the only predictor of the pre-PCI (β = 0.531, p = 0.002) and post-PCI (β = 0.471, p = 0.012) MR was the serum CRP concentration. Likewise, the periprocedural changes in MR was predicted by the serum CRP levels (β = 0.677, p = 0.001) and the presence of angiographic thrombus (β = -0.275, p = 0.02). In conclusion, these results have shown that the CRP level is related to increased coronary MR in the territory of the culprit lesion. This suggests that inflammatory processes might play a role in microvascular impairment in patients with non-ST-segment elevation acute coronary syndrome.
More Related Videos
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...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...