Prognostic value of low and moderately elevated C-reactive protein in acute coronary syndrome: a 2-year follow-up study.
BACKGROUND
The main goal of this study was to improve diagnostic and predictive value of low and moderately elevated C-reactive protein (CRP) in patients with acute coronary syndrome (ACS), related to noninvasive clinical parameters, in order to improve and prolong patient life with low or no additional costs.


METHODS
A prospective, open clinical study was conducted at the University Hospital Split, Croatia with 112 patients with ACS and low or moderately elevated CRP (<3.0 mg/L). After diagnosing ACS, data on physical activity, alcohol consumption, and functional status were recorded. Anthropometric measurements were made. Blood and urine samples were taken for analyses. Electrocardiographic, ergometric, and echocardiographic testing was performed. A total of 72 parameters were monitored at the time of hospital admission in ACS patients to analyze which ones could predict disease outcome at the end of follow-up in patients with low or moderately elevated CRP. Patients were followed up for 2 years.


RESULTS
The variables that were predictive of major adverse cardiac events (MACE) within 2 years of ACS hospitalization were hemoglobin, fibrinogen, antithrombin III, cholesterol levels, brain natriuretic peptide, and microalbuminuria. ACS patients with CRP<3.0 mg/L had significantly higher risk of developing MACE within 2 years if ≥50% of the 8 key parameters were outside the reference values.


CONCLUSIONS
Major adverse cardiac events can be predicted in patients with acute coronary syndrome whose CRP values are low or moderately elevated.
Department of Internal Medicine, University Hospital Split, Split, Croatia.
Ajvor
A
Lukin
Katarina
K
Novak
Stojan
S
Polić
Livia
L
Puljak
D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood*; D001774:Blood Chemical Analysis; D002097:C-Reactive Protein / Q000378:metabolism*; D017523:Croatia; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis
D015415:Biomarkers; D002097:C-Reactive Protein