[Correlation of high-sensitivity CRP concentration with the extent of coronary atherosclerosis in men with symptoms of ischemic heart disease].
Atherogenesis is combined with inflammation of low intensity within endothelium. To-date studies have demonstrated that C-reactive protein is the best marker of this type of inflammation because its concentrations not only reflect the intensity of the process but they also carry prognostic information in apparently healthy general population as well as in patients with symptomatic atherosclerosis. The aim of this study was to evaluate the correlation between high-sensitivity CRP (hsCRP) and the extent of coronary atherosclerosis in men undergoing coronary angiography. The secondary aim was to assess the influence of statin treatment on hsCRP levels by comparing these levels in statin-treated and statin-naive patients.


METHODS
112 men with symptoms of ischemic heart disease were included in the study. In 98 cases coronary angiography was performed 52 patients were treated with statins. The extent of atherosclerosis in the coronary bed was evaluated according to four indexes: Gensini score (G), Friesinger score (F), Number of Vessels Diseased (NVD) and Arterial Segment Score (ASS). Concentrations of hsCRP concentrations were obtained with NB100 Dade-Behring kit. Pearson correlation coefficient was calculated for CRP concentrations following their logarithmic transformation. Correlation evaluation was confined to statin-naive patients due to convincing data about the influence of statins on CRP levels.


RESULTS
A significant correlation between levels of hsCRP and extension of coronary atherosclerosis was found with all used indexes (G: R=0.335; p=0.0151, F: R=0.406; p=0.0028, NVD: R=0.0338; p=0.0142, ASS=0.368; p=0.071). The mean concentration of hsCRP was 27.7% lower in the patients on statins than in statin-naive patients within the low and moderate range of concentrations (up to 70th percentile, 2.4 mg/l) (p<0.02). In 25% of study subjects hsCRP exceeded the level of 3.0 mg/l which is the cut-off value for increased risk of atherothrombotic complications.


CONCLUSIONS
The study showed a significant correlation between hsCRP and the extent of coronary atherosclerosis in men with symptoms of ischemic heart disease. A significantly lower concentration of hsCRP was observed in the group of patients treated with statins compared to statin-naive patients, which may result from the proposed CRP reducing influence of these drugs. A quarter of study subjects had hsCRP levels exceeding the cut-off value for increased cardiovascular risk.
Piechota
Wiktor
W
Wojskowy Instytut Medyczny, Klinika Chorób Wewnetrznych i Kardiologii CSK MON w Warszawie. victorpiech@op.pl
Piechota
Wiesław
W
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000187:drug effects* / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood* / Q000188:drug therapy*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein