title: Value of serial C-reactive protein measurements in non ST-segment elevation acute coronary syndromes.
abstract: BACKGROUND
  Elevated C-reactive protein (CRP) levels at admission are associated with adverse outcomes in patients with non ST-segment elevation acute coronary syndromes (NSTE-ACS).
  
  
  OBJECTIVE
  C-reactive protein measurement not only at admission, but also after admission, may be useful for predicting adverse outcomes in NSTE-ACS.
  
  
  METHODS
  We measured high-sensitivity CRP levels at admission and at 24 h in 215 patients with NSTE-ACS. An elevated CRP level at admission (admission elevation) was defined as a CRP level of >or=0.300 mg/dL. An increase in the CRP level after admission (increase at 24 h) was considered present when the CRP level at 24 h was higher than the level at admission. Patients were divided into 4 groups according to the presence or absence of admission elevation and increase at 24 h. Coronary angiography was performed at a mean of 3 d after admission.
  
  
  RESULTS
  There were no significant differences among the 4 groups in age, sex, coronary risk factors, or multivessel disease. Patients with both admission elevation and increase at 24 h had higher rates of ST-segment depression and positive troponin T at admission. Multivariate analysis showed that admission elevation (odds ratio [OR] 1.50, p<0.05) and increase at 24 h (OR 6.56, p=0.03) were independent predictors of 30-d events (e.g., death, myocardial infarction, or refractory angina). The highest risk of 30-d events was associated with both admission elevation and increase at 24 h.
  
  
  CONCLUSIONS
  Serial CRP measurements are useful for predicting the risk of subsequent ischemic complications in patients with NSTE-ACS.
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ebina
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Endo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mitsuhashi
authors.forename: Katsutaka
authors.initials: K
authors.lastname: Hashiba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
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