title: C-reactive protein in predicting coronary artery disease in subjects with aortic valve sclerosis before diagnostic coronary angiography.
abstract: BACKGROUND
  Although previous studies have suggested that aortic valve sclerosis (AVS) shares common histologic features with atherosclerosis and is an indicator of significant coronary artery disease (CAD), many patients with aortic valve disease do not have coexisting coronary atherosclerotic disease and vice versa. It is important to find the subjects with AVS who are most likely to have concomitant CAD and require aggressive evaluation.
  
  
  OBJECTIVE
  We hypothesized that the systemic inflammatory marker, high-sensitive C-reactive protein (hs-CRP), may be associated with AVS, and may be helpful before coronary angiography in identifying the presence of concomitant CAD in patients with AVS.
  
  
  METHODS
  This study included 227 patients with suspected CAD undergoing transthoracic echocardiography and coronary angiography. AVS was defined as a focal area of increased echogenicity and thickening of the aortic valve leaflets without restriction in motion. Data of atherosclerotic risk factors including hs-CRP were collected.
  
  
  RESULTS
  Technically satisfactory ultrasound recordings were obtained in 217 subjects (96% of enrolled patients). Patients with AVS were older (65+/-10 vs. 60+/-10 years old; P=0.0004), had higher serum creatinine levels (115.2+/-79.7 vs. 88.6 +/-35.4 micromol/L; P=0.04), and had greater prevalence of obstructive CAD (75% vs. 53%; P=0.001) than those with normal aortic valves. CRP levels were not associated with AVS, and failed to predict concomitant CAD in patients with AVS. Additionally, none of the established risk factors were independent predictors of the presence of CAD in AVS patients.
  
  
  CONCLUSIONS
  Hs-CRP levels appear to not be associated with AVS, and are of little value in terms of predicting the presence of concurrent CAD before coronary procedure.
authors.affiliation: Division of Cardiology, Buddhist Tzu Chi General Hospital, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan. shunyi57@tzuchi.com.tw
authors.forename: Shun-Yi
authors.initials: SY
authors.lastname: Hsu
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hung
authors.forename: Shan-Hung
authors.initials: SH
authors.lastname: Chang
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
mesh_terms: D000367:Age Factors; D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D002097:C-Reactive Protein / Q000032:analysis*; D008076:Cholesterol, HDL / Q000097:blood; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003326:Coronary Circulation; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012598:Sclerosis
chemical_list: D008076:Cholesterol, HDL; D006710:Homocysteine; D002097:C-Reactive Protein