A Study of C-Reactive Protein Levels in Acute Coronary Syndrome and a Correlation With the Outcome

Abstract

BACKGROUND Coronary artery disease has emerged as the major cardiovascular disease of the era and also the commonest cause of premature death. Developing countries like India are expected to experience the greatest rise in cardiovascular disease burden over the next few years. In large part, this increase can be explained on the basis of major ongoing socio-demographic changes in developing countries and associated effects on the number of individuals at risk and the levels of cardiovascular risk factors. Atherosclerosis of the coronary vessels commonly causes ischaemic heart diseases. Recently, attention has been focused on the potential role of plasma markers of inflammation, especially C-Reactive Protein (CRP), as risk predictors among those at risk for cardiovascular events. Circulating levels of CRP were found to correlate with total infarct size in acute myocardial infarction and with prognosis. This study was conducted to identify the role of C-reactive protein in correlating the outcome in acute coronary syndrome. MATERIALS AND METHODS This is a case series study done in ICCU of VIMS, Bellary for a period of one year; 100 patients who came with history of typical angina chest pain and those who fit into the criteria for Acute Coronary syndrome with ECG showing either ST segment elevation or non-ST segment elevation myocardial infarction or unstable angina were included in the study. Detailed history, clinical examination and laboratory tests were the tools used to exclude these conditions. Apart from routine blood investigations, electrocardiography and transthoracic echocardiography was done in all patients. All patients were followed up and observed for the development of complications. RESULTS Out of the 100 patients studied, 44 patients had detectable C-reactive protein levels (equal to or more than 0.6 mg/dL). Out of these 34 patients had complications (including death), which was found to be statistically significant, thus correlating the CRP levels with complications. CONCLUSION Our study highlights a possible correlation between CRP levels and adverse outcome in acute coronary syndrome. Plasma CRP levels on admission serves to identify high risk patients in the setting of acute coronary syndromes and are also independent markers of adverse outcomes. The effective risk stratification provided may be of specific value for early therapeutic decisi on making and patient treatment in the heterogeneous population of patients presenting with acute coronary syndromes.