High-sensitivity C-reactive protein and exercise-induced changes in subjects suspected of coronary artery disease.
BACKGROUND
Inflammation plays a major role in the development of atherosclerosis. We wanted to investigate the effects of exercise on high-sensitivity (hs) C-reactive protein (CRP) in subjects who were suspected of having coronary artery disease (CAD).


METHODS
Blood samples were obtained before, 5 minutes after, and 20 hours after an exercise test in 155 subjects who were suspected of CAD. Coronary anatomy was evaluated by computed tomography coronary angiography and/or coronary angiography.


RESULTS
Median baseline hs-CRP was higher in subjects with ≥50% coronary artery lumen diameter stenosis (n=41), compared with non-CAD-subjects (n=114), 2.93 mg/L (interquartile range 1.03-5.06 mg/L) and 1.30 mg/L (interquartile range 0.76-2.74 mg/L), respectively, P=0.007. In multivariate analyses testing conventional risk factors, hs-CRP proved borderline significant, odds ratio =2.32, P=0.065. Adding baseline hs-CRP to the results of the exercise test did not improve the diagnostic evaluation. Baseline natural logarithm (Ln) hs-CRP was positively associated with body mass index and baseline Ln-transformed hs troponin T levels, and negatively associated with the daily life activity level. An increase in hs-CRP of 0.13 mg/L (interquartile range 0.05-0.24 mg/L) from baseline to 5 minutes after peak exercise was found (P<0.0001), but the increase was not associated with presence of CAD. From baseline to 20 hours after exercise, no increase in hs-CRP was found.


CONCLUSIONS
In conclusion, hs-CRP was not independently associated with CAD. Hs-CRP increased immediately as a response to the exercise, and the increase was modest and not associated with CAD. The results indicate that exercise has potential to cause unwanted variations in hs-CRP and that exercise prior to hs-CRP measurements in subjects included in epidemiological studies, therefore, should be avoided.
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark.
Mette Rauhe
MR
Mouridsen
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark.
Olav Wendelboe
OW
Nielsen
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark.
Christian Malchau
CM
Carlsen
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark.
Nick
N
Mattsson
Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.
Martin H
MH
Ruwald
Department of Cardiology, Herlev Hospital, Herlev, Denmark.
Zeynep
Z
Binici
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark.
Ahmad
A
Sajadieh
atherosclerosis; exercise testing; inflammation; stable angina pectoris