C-reactive protein and lesion morphology in patients with acute myocardial infarction.
BACKGROUND
Elevated serum C-reactive protein (CRP) is of clinical significance in the management of acute coronary syndromes, but there have been few in vivo studies detailing the relation between lesion morphology and elevated CRP in the setting of acute myocardial infarction (AMI). In this study, we investigated the relation between lesion morphology as seen under preintervention intravascular ultrasound (IVUS) and CRP in the acute phase of AMI.


RESULTS
Our patient population comprised 90 consecutive patients with AMI who underwent preintervention IVUS within 6 hours of the onset of symptoms. Patients were divided into an elevated CRP group (> or =3 mg/L) or a normal CRP group on the basis of serum CRP levels. There were no differences in patient characteristics or angiographic findings. We observed significantly more plaque rupture in the elevated CRP group than in the normal CRP group (70% versus 43%, P=0.01). A multivariate logistic regression model revealed that the presence of ruptured plaque alone correlated with elevation of serum CRP (P=0.02; odds ratio, 3.35; 95% CI, 1.22 to 9.18).


CONCLUSIONS
Elevated CRP may be related to the presence of ruptured plaque. Our results suggest that in the setting of AMI, elevated CRP levels may reflect the inflammatory activity of a ruptured plaque.
Sano
Toshihiko
T
Baba Memorial Hospital, Sakai, Japan.
Tanaka
Atsushi
A
Namba
Masashi
M
Nishibori
Yoshiharu
Y
Nishida
Yukio
Y
Kawarabayashi
Takahiko
T
Fukuda
Daiju
D
Shimada
Kenei
K
Yoshikawa
Junichi
J
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D018450:Disease Progression; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging; D020107:Troponin T / Q000097:blood; D018084:Ultrasonography, Interventional
D015415:Biomarkers; D007527:Isoenzymes; D020107:Troponin T; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form