Markers of Myocardial Damage and Inflammation in Relation to Long-Term Mortality in Unstable Coronary Artery Disease

Lindahl, Bertil; Toss, Henrik; Siegbahn, Agneta; Venge, Per; Wallentin, Lars

doi:10.1056/nejm200010193431602

Cited by 1,104 publications

(669 citation statements)

References 40 publications

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“…CRP is now recognized as an important marker of cardiovascular risk and reflects possible pathogenetic processes, which may relate to specific organisms or to general pathogen burdens. 21,22 However, the CRP was not related to kava use and neither were homocysteine levels, another cardiovascular risk marker, which were also generally elevated.…”

Section: Discussionmentioning

confidence: 94%

Health effects of kava use in an eastern Arnhem Land Aboriginal community

Clough

Jacups

Wang

et al. 2003

Internal Medicine Journal

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Background: Heavy kava use in Aboriginal communities has been linked to various health effects, including anecdotes of sudden cardiac deaths. Aims: To examine associations between kava use and potential health effects. Methods: A cross-sectional study was carried out within a kava-using east Arnhem Land Aboriginal community in tropical northern Australia. One-hundred-and-one adults who were current, recent or non-users of kava were enrolled in March 2000. Main outcome measures were physical, anthropometric, biochemical, haematological, immunological and neurocognitive assessments. Results: Kava users more frequently showed a characteristic dermopathy (P < 0.001). They had increased levels of γ-glutamyl transferase and alkaline phosphatase (P < 0.001). Lymphocyte counts were significantly lower in kava users (P < 0.001). Fibrinogen, plasminogen activator inhibitor-1 and neurocognitive tests were not different between kava use categories. IgE and IgG antibodies were elevated across the whole group, as were C-reactive protein and homocysteine. Conclusions: Kava use was associated with dermopathy, liver function abnormalities and decreased lymphocytes. If kava continues to be used by Aboriginal populations, monitoring should focus on the health consequences of these findings, including a possible increase in serious infections. The interaction between kava, alcohol and other substances requires further study. Although markers of cardiovascular risk are increased across the population, these were not higher in kava users, and this increase may be linked to the large infectious pathogen burden reflective of the socioeconomic disadvantage seen in many remote Aboriginal communities. (Intern Med J 2003; 33: 336-340)

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Section: Discussionmentioning

confidence: 94%

Health effects of kava use in an eastern Arnhem Land Aboriginal community

Clough

Jacups

Wang

et al. 2003

Internal Medicine Journal

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“…Furthermore, among patients with angina pectoris, increases in CRP concentrations were associated with unfavorable short-and long-term outcomes. [14][15][16][17] In more recent years, several nested case-control and cohort studies have also reported that the risk for CVD was related to baseline CRP concentrations. 18,19 This relation was interpreted as a confirmation of the role of CRP itself as a risk factor for coronary disease by inducing mononuclear cells to express tissue factor, the initiator of the extrinsic pathway of coagulation, further stimulating vascular thrombosis.…”

Section: Introductionmentioning

confidence: 99%

C‐reactive protein as a marker for active coronary artery disease in patients with chest pain in the emergency room

Magadle

Weiner

Beckerman

et al. 2002

Clinical Cardiology

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SummaryBackground: Markers of inflammation, such as C-reactive protein (CRP), were found to be related to risk for cardiovascular disease (CVD) events in patients with angina pectoris. In addition, recent studies have shown that, in the case of atherosclerosis, increased CRP concentration reflects the inflammatory condition of the vascular wall.Hypothesis: The study was undertaken to determine whether CRP levels in individuals with chest pain attending the emergency room (ER) may be used as a marker of active CVD.Methods: Serum CRP level was measured in 226 of 326 consecutive patients (128 men, 98 women; mean age 61.3 ± 5.9 years; range 19-87 years) referred to the ER with chest pain. The decision whether to admit or release the subjects was determined without taking the CRP level into account. Follow-up was then performed for 1 year.Results: Eighty-four patients were admitted to the hospital. Of these, 9 with acute coronary syndrome (ACS) had very high levels of CRP (25-40 mg/l), 35 had had an acute coronary event within the preceding 3 months, with levels of CRP 14-20 mg/l. Only eight patients with nonsignificant CVD had elevated CRP levels. Twenty-eight subjects who were released from the ER had elevated CRP levels (7-14 mg/l); 8 of these, in addition to 4 subjects with normal CRP levels, had a late coronary event.

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“…High-sensitivity C-reactive protein (CRP), a marker of inflammation, has been identified as an independent predictor of adverse cardiac events in healthy populations and in patients with stable coronary artery disease or ACS (6)(7)(8)(9)(10)(11). Although it is clear that inflammation plays a role in atherosclerotic complications (12), the relationship between CRP and troponin release following PCI has not been clarified.…”

mentioning

confidence: 99%