High Sensitivity C-Reactive Protein and Carotid Intima Media Thickness as Dual Predictors of Short Term Outcome in Patients with Acute Coronary Syndrome

Introduction: Prediction of cardiovascular risk is of paramount importance particularly in patients with acute coronary syndrome. Traditional risk factors & existing models are still insufficient to close the detection gap. Aim of the Work: To assess the relation between both high sensitively c-reactive protein, carotid intimae media thickness and short term outcome in patients with acute coronary syndrome. Subjects and Methods: The present study enrolled 50 patients with acute coronary syndrome: 23 patients with STEMI representing group I, 27 patients with unstable angina representing group II. All patients were subjected to: History taking, physical examination, twelve leads ECG daily & as required, as well as Echocardiography-carotid Dopplex examination. Laboratory investigations including: Fasting blood sugar, lipid profile cardiac enzymes (CPK, troponin, LDH) serum creatinine & hsCRP. Medical Protocol: All patients received the standard treatment of unstable angina or STEMI according to their presentations & followed-up during hospital stay & three months for recurrent pain, recurrent infarction, PCI, CABG & death. Results: There was no significant difference between myocardial infarction group and unstable angina group as regards age, (55.87±7.42 vs 56.29±8.49), male sex (95.7 vs 85.2) diabetes (13% vs 29.6%), hypertension (39.8% vs 40.7%), smoking (52.2% vs 33.3%) & obesity (43.5 vs 37%). Only, dyslipidaemia was significantly higher in MI group than UA group (60.9% vs 22.2% p-value <0.001). There was no significant difference between both groups as regard cholesterol, TG, HDL, LDL, hsCRP & CIMT. Also, there was no significant difference as regards LVESD, LV EDD & EF. Correspondence to: Dr. Ghad Soltan, E-mail:[email protected]. Correlation between CIMT & adverse events (including anginal pain, reinfarction, HF, PCI, CABG & death) were non significant in both MI & UA groups p-value 0.05). On the other hand significant positive correlation was found between hs CRP and CABG & death in both groups. Conclusion: Carotid Intima media thickness has poor correlation with short term clinical outcome in patients with acute coronary syndrome while Hs CRP has significant positive correlation particularly with CABG & death.