Comparison of C-reactive protein and terminal complement complex in patients with unstable angina pectoris versus stable angina pectoris.
Elevated C-reactive protein (CRP) can identify patients with coronary artery disease who are prone to future acute events. We investigated whether elevated CRP is related to the activation of the terminal complement cascade in 66 patients with unstable angina pectoris (UAP), in 45 patients with stable angina pectoris, and in 42 controls. CRP, additional acute phase reactants, the terminal complement complex (sC5b-9), leukocytes, and troponin T were measured. In 47 patients with UAP the CRP values were regarded as elevated (>0.3 mg/dl). In patients with UAP and elevated CRP, the plasma levels of sC5b-9 were markedly higher than in patients with UAP and lower CRP (245 +/- 14 vs 188 +/- 19 ng/ml, p <0.02) and in patients with stable angina pectoris with slightly (0.4 +/- 0.1 mg/dl) increased CRP (sC5b-9 173 +/- 21 vs 130 +/- 7 ng/ml [controls; p <0.05]). A further acute phase reaction was present only in patients with UAP and elevated CRP already on admission (p <0.01). sC5b-9 was not related to troponin release. Thus, elevated CRP levels are associated with activation of the plaque destabilizating terminal complement system in patients with UAP during the acute phase reaction. This may explain the prognostic value of CRP in acute coronary syndromes (ACS).
Hoffmeister
Hans Martin
HM
Klinik für Kardiologie und Allgemeine Innere Medizin, Stäedtisches Klinikum Solingen, Solingen, Germany. hoffmeister@klinikumsolingen.de
Ehlers
Raila
R
Büttcher
Evi
E
Kazmaier
Silke
S
Szabo
Sebastian
S
Beyer
Martin E
ME
Steinmetz
Armin
A
Seipel
Ludger
L
D000210:Acute-Phase Reaction; D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000276:immunology*; D000789:Angina, Unstable / Q000097:blood / Q000276:immunology*; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D003167:Complement Activation; D015938:Complement Membrane Attack Complex / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D020107:Troponin T / Q000097:blood
D015938:Complement Membrane Attack Complex; D020107:Troponin T; D002097:C-Reactive Protein