The role of high-sensitivity C-reactive protein for assessing coronary artery disease severity and left ventricular end diastolic pressure in patients with suspected coronary artery disease

OBJECTIVE

Much attention has recently been focused on the underlying role of circulating inflammatory biomarkers such as high-sensitivity C-reactive protein for predicting cardiovascular disease progression. We therefore set out to assess the relationship between the value of high-sensitivity C-reactive protein and (i) coronary artery disease severity, and (ii) left ventricular end diastolic pressure.

DESIGN

A cross-sectional study.

SETTING

The Shafa hospital in Kerman, Iran.

PATIENTS

A total of 107 consecutive patients referred for coronary angiography from January 2008 to January 2009 were prospectively studied.

INTERVENTION AND MAIN OUTCOME MEASURES

All patients underwent coronary angiography. They all had undergone left ventricular end diastolic pressure measurement, involving a 6-Fr pigtail catheter and a properly zeroed fluid-filled pressure transducer. For each patient, the level of high-sensitivity C-reactive protein was also determined using enzyme-linked immunosorbent assay kits.

RESULTS

The high-sensitivity C-reactive protein levels could strongly predict increased left ventricular end diastolic pressure (standardised beta=1.010; P=0.008), with other patient variables being confounders, but there was no significant association between these levels and Gensini scores. Multiple linear regression analysis showed that among the study parameters, systolic hypertension (standardised beta=1.611; P=0.047) and a family history of coronary artery disease (standardised beta=1.911; P=0.005) were the main predictors of high Gensini scores in study patients.

CONCLUSION

High-sensitivity C-reactive protein level is a clinical parameter that could predict left ventricular end diastolic pressure and left ventricular dysfunction, but was not associated with the severity of coronary artery disease.

Coronary Artery Disease Risk Factors in an Urban and Peri-urban Setting, Kerman, Southeastern Iran (KERCADR Study): Methodology and Preliminary Report

BACKGROUND

This article was to present the sampling and measurements methods and the main preliminary findings of the KERCADR cohort study (first round) in an urban and peri-urban setting, Kerman, southeastern Iran 2009-11.

METHOD

5900 (3238 female) people aged between 15 to 75 years were recruited in the household survey by non-proportional to size one-stage cluster sampling. Trained internal specialists, general practitioners, clinical psychologists and dentists have assessed the study subjects by person-assisted questionnaires regarding different NCD risk factors including cigarette and opium smoking, physical activity, nutrition habits, anxiety, depression, obesity, hypertension and oral health. Blood samples were also collected for determining FBS, HbA1c, cholesterol and triglyceride. Weighted standardized prevalence estimates were calculated by STATA 10 survey analysis package.

RESULTS

The participation rate was more than 95% in all subgroups. Cigarette smoking (18.4% vs. 1.2%), opium use (17.8% vs. 3.0%) and triglyceridemia (16.1% vs. 12.0%) were significantly higher among men than women. In contrast, women were presented with higher level of sever anxiety (29.1% vs. 16.7%), obesity (16.8% vs. 9.2%), low-physical activity (45.1% vs. 39.2%) and uncontrolled diabetes (60.2% vs. 31.0%). More than 68% of all subjects have presented with moderate to severe gingival index scores.

CONCLUSION

The first round of the KERCADR cohort with sufficient sample size and response rate provided precise estimates for the main clinical and para-clinical NCD risk factors. These evidences need to be translated into public health interventions and monitored in the next rounds of the cohort.

Relationship between serum level of high-sensitive C-reactive protein and extension of myocardial involvement in patients with acute myocardial infarction

INTRODUCTION

The high-sensitive C-reactive protein (HS-CRP) assay is being increasingly used as a marker for cardiac risk assessment and as a prognostic tool in heart disease. In current study, we assessed the relationship between serum level of HS-CRP and extension of myocardial involvement in acute myocardial infarction.

METHODS

In a cross-sectional study, 50 patients with the final diagnosis of acute myocardial infarction and admitted for the first time in CCU wards of the Kerman University in 2010 were studied. Serum HS-CRP and Troponin I level was measured using commercial ELISA kits, 24 hours after the appearance of first manifestations. All patients underwent 2-dimensional echocardiography for assessing the number and severity of involved segments as well as wall motion abnormality.

RESULTS

There was a strong positive correlation between the serum level of HS-CRP and serum Troponin I level (beta = 0.509, p < 0.001). Multivariable linear regression showed that the level of HS-CRP could strongly predict serum level of Troponin I within the first 24 hours of MI appearance (Beta = 0.308, Standard Error = 0.080, p < 0.001). But, no significant relationships were revealed between the mean serum HS-CRP level and the location of myocardial infarction, the number of involved segments, left ventricular ejection fraction, and ST-segment elevation score.

CONCLUSION

For a strong correlation between HS-CRP and Troponin I, HS-CRP can be a useful biomarker for predicting extended myocardial involvement in patients with acute myocardial infarction.