Impact of the metabolic syndrome on high-sensitivity C reactive protein levels in patients with acute coronary syndrome.
OBJECTIVE
Underlying predisposition for a heightened inflammatory response is postulated as one of the mechanisms for elevated high-sensitivity C reactive protein (hs-CRP) levels in patients with acute coronary syndrome (ACS). It is unclear whether metabolic syndrome (MetS) may cause a predisposition for heightened hs-CRP response in patients with ACS. The aim of this study is to investigate the interaction between hs-CRP levels and presence of MetS in patients with and without ACS.


METHODS
Two hundred and seventy-three consecutive patients presenting with a first ACS event and 261 MetS patients without any ACS event were included to the study. The study participants were divided into three groups as MetS (+) ACS (-) [n=261], MetS (-) ACS (+) [n=110], and MetS (+) ACS (+) [n=163]. Median levels of hs-CRP were compared between and within the three groups.


RESULTS
Hs-CRP levels were lowest in MetS (+) ACS (-) subjects and highest in MetS (+) ACS (+) patients. Factors associated with hs-CRP levels were troponin elevation, presence of ACS, body mass index (BMI), and presence of MetS (R(2)=0.26, p<0.01). Predictors of elevated hs-CRP levels (>0.3mg/dl) were the presence of ACS (OR=3.6, 95% CI=1.9-6.5, p<0.01), presence of MetS (OR=2.1, 95% CI=1.0-4.0, p=0.02), troponin elevation (OR=5.7, 95% CI=2.8-11.5, p<0.01) and BMI (OR=1.1, 95% CI=1.0-1.1, p<0.01).


CONCLUSIONS
The presence of MetS had an impact on the increase in hs-CRP levels observed with an ACS event in the study population. These findings suggested that a heightened baseline inflammatory status of MetS may predispose ACS patients to an augmented hs-CRP response.
Kilic
Teoman
T
Kocaeli University Medical Faculty, Department of Cardiology, Kocaeli, Turkey. kilicteoman@yahoo.com
Jneid
Hani
H
Ural
Ertan
E
Oner
Gokhan
G
Sahin
Tayfun
T
Kozdag
Guliz
G
Kahraman
Goksel
G
Ural
Dilek
D
D054058:Acute Coronary Syndrome / Q000097:blood / Q000209:etiology*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D014336:Troponin / Q000097:blood; D015854:Up-Regulation
D015415:Biomarkers; D018836:Inflammation Mediators; D014336:Troponin; D002097:C-Reactive Protein