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High Sensitive CRP Level Is Associated With Intermediate and High Syntax Score in Patients With Acute Coronary
Muhammed Karadeniz1, Mustafa Duran, Ahmet Akyel
1Department of Cardiology, Ankara Education and Research Hospital.
Insights
High sensitive C-reactive protein (hs-CRP) levels predict coronary atherosclerosis severity in acute coronary syndrome (ACS) patients. Elevated hs-CRP indicates a higher SYNTAX score, suggesting more complex coronary artery disease.
Area of Science:
- Cardiology
- Biomarkers
- Atherosclerosis
Background:
- High sensitive C-reactive protein (hs-CRP) is linked to mortality in acute coronary syndrome (ACS).
- The relationship between baseline hs-CRP and coronary atherosclerosis burden, assessed by SYNTAX score (SXScore), requires further investigation.
Purpose of the Study:
- To determine if baseline hs-CRP levels correlate with the SYNTAX score in ACS patients.
- To identify predictors of high SXScore in ACS.
Main Methods:
- 321 ACS patients undergoing coronary angiography were analyzed.
- Patients were stratified into tertiles based on SXScore (low ≤ 22, intermediate-high ≥ 23).
- Multivariate logistic regression identified predictors of high SXScore.
Main Results:
- Patients in the intermediate-high SXScore tertile had significantly higher hs-CRP levels (7.7 ± 3.4 mg/L) compared to the low SXScore tertile (4.9 ± 2.5 mg/L).
- Higher age and diabetes prevalence were observed in the intermediate-high SXScore group.
- Increased hs-CRP (OR: 1.14) was a strong predictor of high SXScore, alongside multivessel disease, LVEF, and troponin levels.
Conclusions:
- Baseline hs-CRP levels can predict the severity and complexity of coronary atherosclerosis in ACS patients.
- hs-CRP is a valuable biomarker for assessing coronary artery disease burden, complementing traditional markers like multivessel disease, LVEF, and troponin.
Abstract:
High sensitive C-reactive protein (hs-CRP) levels are associated with short- and long-term mortality in patients with acute coronary syndrome (ACS). We investigated whether baseline hs-CRP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore).We enrolled 321 patients with ACS who underwent coronary angiography. The patients were divided into tertiles according to the SXScore: low SXScore (≤ 22), and intermediate-high SXScore (≥ 23).Subjects in the intermediate-high SXScore tertile had higher serum hs-CRP levels compare to low SXScore tertile patients (7.7 ± 3.4 mg/L versus 4.9 ± 2.5 mg/L, P < 0.001). The mean age of patients and prevalance of diabetes in the intermediate-high SXScore tertile were significantly higher than in the low SXScore tertile (63 ± 13 versus 58 ± 12 years P = 0.001 for age, P = 0.007 for diabetes). Multivariate logistic regression analysis showed that the strongest predictors of high SXScore were increased serum hs-CRP levels (OR: 1.14) together with multivessel disease (OR: 0.23), left ventricular ejection fraction (LVEF) (OR: 0.90), and troponin levels (OR: 1.12).Serum hs-CRP levels on admission in patients with ACS could predict the severity and complexity of coronary atherosclerosis together with multivessel disease, LVEF, and troponin levels. Thus, increased serum levels of hs-CRP were one of the strong predictors of high SXScore in ACS patients.
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