title: [Relationship of C-reactive protein levels with angiographic findings and markers of necrosis in non-ST-segment elevation acute coronary syndrome].
abstract: OBJECTIVE
  The mechanism responsible for elevated C-reactive protein levels (inflammation of the ruptured atherosclerotic plaque or myocardial necrosis) in acute coronary syndromes is controversial. The aim of this study was to investigate the relationship between C-reactive protein levels and angiographic complexity of the culprit lesion and troponin elevation in patients with non-ST elevation acute coronary syndromes.
  
  
  METHODS
  The study group consisted of 125 patients with single-vessel disease. Troponin-I and C-reactive protein were measured, and the complexity of the culprit lesion was analyzed (TIMI flow and thrombus). Information on age, sex, smoking habit, hypertension, hypercholesterolemia and diabetes was obtained from the medical record.
  
  
  RESULTS
  The quartile distribution of C-reactive protein showed more patients with TIMI flow < 3 (31%, 28%, 18%, and 55%; P=.02), thrombus (3%, 6%, 7%, and 28%; P=.007) and troponin-I elevation (19%, 44%, 50%, and 66%; P=.003) in the fourth quartile. Multivariate analysis showed both thrombus (OR = 4.1; 95% CI, 1.2-14.3; P=.03) and troponin elevation (OR = 2.6; 95% CI, 1.1-6.3; P=.03) to be associated with C-reactive protein > 18 mg/L (fourth quartile cut-off). When treated as a continuous variable, higher levels of C-reactive protein were also associated with thrombus (P=.02) and troponin elevation (P=.003). No other clinical variables were related with C-reactive protein levels.
  
  
  CONCLUSIONS
  Both angiographic complexity of the culprit lesion and elevated troponin level are related with increased C-reactive protein levels in non-ST elevation acute coronary syndromes.
authors.affiliation: Servei de Cardiologia, Hospital Clínic Universitari, Universitat de València, València, España. sanchis_juafor@gva.es
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchís
authors.forename: Vicent
authors.initials: V
authors.lastname: Bodí
authors.forename: Angel
authors.initials: A
authors.lastname: Llácer
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Facila
authors.forename: Angel
authors.initials: A
authors.lastname: Martínez-Brotons
authors.forename: Luis
authors.initials: L
authors.lastname: Insa
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013577:Syndrome; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D002097:C-Reactive Protein