High-sensitivity C-reactive protein and plaque composition in patients with stable angina pectoris: a virtual histology intravascular ultrasound study.
OBJECTIVE
Elevated high-sensitivity C-reactive protein (hs-CRP) is related to clinical outcome in coronary artery disease. We used virtual histology intravascular ultrasound to evaluate the relationship between serum hs-CRP level and coronary plaque composition in patients with stable angina pectoris.


RESULTS
Overall 113 consecutive patients with stable angina pectoris who had a de-novo culprit lesion were examined in this study. Patients were divided into an elevated hs-CRP group (>3 mg/l; n=40) or a normal hs-CRP group (n=73). Grayscale and virtual histology intravascular ultrasound analysis was performed across the entire culprit lesion. Mean plaque area was similar in both groups. Lesion length (18+/-5 vs. 16+/-6 mm, P<0.046) was significantly greater in the elevated hs-CRP group than that in the normal hs-CRP group. Although the percentage of dense calcium, fibrofatty tissue, and fibrous tissue was not different between the two groups, the percentage of necrotic core was significantly greater in the elevated hs-CRP group compared with the normal hs-CRP group (20+/-9 vs. 16+/-8%, P=0.014). The percentage of necrotic core was positively correlated with the serum hs-CRP level (r=0.20, P=0.037). A multivariate logistic regression model showed that the percentage of necrotic core was associated with elevated hs-CRP (P=0.019; odds ratio=1.1; 95% confidence interval=1.01-1.12).


CONCLUSIONS
Elevated hs-CRP was related to the amount of necrotic core in the culprit lesion of stable angina pectoris. Our results suggest that elevated hs-CRP might reflect the inflammatory activity of the coronary atherosclerotic plaque even in the setting of stable angina pectoris.
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Takashi
T
Kubo
Yoshiki
Y
Matsuo
Yasushi
Y
Hayashi
Takashi
T
Yamano
Takashi
T
Tanimoto
Yasushi
Y
Ino
Hironori
H
Kitabata
Shigeho
S
Takarada
Kumiko
K
Hirata
Atsushi
A
Tanaka
Nobuo
N
Nakamura
Masato
M
Mizukoshi
Toshio
T
Imanishi
Takashi
T
Akasaka
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000276:immunology; D003324:Coronary Artery Disease / Q000150:complications / Q000276:immunology* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000276:immunology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D018084:Ultrasonography, Interventional; D015854:Up-Regulation
D015415:Biomarkers; D002097:C-Reactive Protein