title: Relationship between C-reactive protein and the electrocardiographic pattern on admission in patients with acute coronary syndrome.
abstract: BACKGROUND
  In patients with acute coronary syndrome (ACS), the prevalence of a primary inflammatory pathogenic component of coronary instability, as detectable by elevated C-reactive protein (CRP), varies considerably. The aim of the present study was to assess the prevalence of inflammation in patients with ACS according to the different electrocardiographic (ECG) patterns on admission.
  
  
  METHODS
  Hundred and thirty-six consecutive patients with the diagnosis of acute myocardial infarction were divided in three groups according to the ECG pattern on admission. Group 1 included 59 patients with ST segment elevation, group 2 included 50 patients with ST depression and/or T wave inversion and group 3 included 27 patients with no ECG changes. CRP was measured on admission in all patients. For the prevalence of inflammation analysis, we used a cutoff value of 3 mg/l.
  
  
  RESULTS
  CRP was above cutpoint significantly more often in patients with ST depression and/or T wave inversion (44.1% in group 1, 70% in group 2 and 40.7% in group 3; p=0.009). Patients with similar ECG pattern and CRP levels above the cutpoint presented a poorer outcome (coronary death, myocardial infarction and recurrence of instability) at one-year follow-up: 54 versus 27% for group 1, 74 versus 27% for group 2 and 45 versus 31% for group 3.
  
  
  CONCLUSIONS
  Patients with ST depression and/or T wave inversion on admission exhibit a higher prevalence of elevated CRP than those with ST elevation or no ECG changes, suggesting an important heterogeneity of the role of inflammatory triggers of the clinical syndromes of coronary instability.
authors.affiliation: Cardiology Department, University Hospital, Salamanca, Spain. pedrolsanchez@secardiologia.es
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Sánchez
authors.forename: Igor F
authors.initials: IF
authors.lastname: Palacios
authors.forename: Pedro
authors.initials: P
authors.lastname: Pabón
authors.forename: Ignacio
authors.initials: I
authors.lastname: Santos
authors.forename: M Victoria
authors.initials: MV
authors.lastname: Rodríguez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villacorta
authors.forename: Javier
authors.initials: J
authors.lastname: Martin-Moreiras
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cruz
authors.forename: Candido
authors.initials: C
authors.lastname: Martin-Luengo
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology*; D011379:Prognosis
chemical_list: D002097:C-Reactive Protein