title: Value of C-reactive protein as a risk factor for acute coronary syndrome: a comparison with apolipoprotein concentrations and lipid profile.
abstract: OBJECTIVE
  To investigate whether assessment of C-reactive protein (CRP) and apolipoproteins, besides the traditional lipid profile, enhances the assessment process for the risk of acute coronary syndrome (ACS).
  
  
  METHODS
  The study group consisted of 220 consecutive patients admitted to hospital within the first 6 hours from the onset of chest pain. Patients were diagnosed with unstable angina (n = 96), non-ST-elevation myocardial infarction (NSTEMI; n = 57), or ST-elevation myocardial infarction (STEMI; n = 67). ACS patients were compared with 116 healthy volunteers in a case-control study. The serum was assayed on admission for CRP, apolipoproteins ApoAI and ApoB100, and lipid parameters.
  
  
  RESULTS
  The highest concentrations of CRP were found in NSTEMI and STEMI, with a median value four-fold higher in ACS patients than in controls (P < 0.0001). Only CRP significantly increased the probability of ACS development (adjusted odds ratio for a 1 mg/L increase 1.90; 95% confidence interval [CI] 1.34-2.89) and explained 90% of the variation for ACS development. Similarly, we demonstrated the highest diagnostic accuracy for CRP among all investigated markers (area under the curve 0.80; 95% CI 0.75-0.85).
  
  
  CONCLUSIONS
  Our study indicates that CRP superiorly to apolipoproteins and lipid profile facilitates the risk stratification for ACS occurrence.
authors.affiliation: Department of Laboratory Medicine, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland. krintus@wp.pl
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krintus
authors.forename: Marek
authors.initials: M
authors.lastname: Kozinski
authors.forename: Anna
authors.initials: A
authors.lastname: Stefanska
authors.forename: Marcin
authors.initials: M
authors.lastname: Sawicki
authors.forename: Karolina
authors.initials: K
authors.lastname: Obonska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Fabiszak
authors.forename: Jacek
authors.initials: J
authors.lastname: Kubica
authors.forename: Grazyna
authors.initials: G
authors.lastname: Sypniewska
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000378:metabolism*; D000368:Aged; D016632:Apolipoprotein A-I / Q000378:metabolism; D053299:Apolipoprotein B-100 / Q000378:metabolism; D001053:Apolipoproteins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000378:metabolism; D012307:Risk Factors
chemical_list: D016632:Apolipoprotein A-I; D053299:Apolipoprotein B-100; D001053:Apolipoproteins; D008055:Lipids; D002097:C-Reactive Protein