High sensitivity C-reactive protein levels across spectrum and severity of coronary artery disease

Background: C-reactive protein (CRP) is an acute-phase reactant protein synthesized by the liver in response to acute stress in a wide range of acute and chronic inflammatory conditions. In healthy subjects and patients presenting with coronary artery disease (CAD), elevated levels of CRP has repeatedly been demonstrated to predict future cardiovascular events. Methods: We measured high sensitivity C-reactive protein (hs-CRP) levels in 382 consecutive patients with CAD and 60 healthy controls by immunoturbidimetry method. Risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking, obesity and family history of premature CAD were assessed. Results: The mean age of patients with CAD was 53.5±11.8 years (303 males) and that of control group was 50.83±8.07(28 males). The patient group had significant higher concentration of mean hs-CRP levels when compared with the healthy control group (1.8±1.9 mg/L vs 0.35±1.1 mg/L, p<0.001). The mean hs-CRP levels of unstable angina (USA) and myocardial infarction (MI) patients was higher than chronic stable angina (CSA) patients (p<0.05). Based on the disease severity, we found a significantly higher hs-CRP levels in patients of triple vessel disease when compared to patients with single vessel disease (p=0.01). Conclusions: Elevated serum hs-CRP levels provide a useful marker for cardiovascular risk which, when combined with traditional risk factors, may help improve global risk prediction. Our study showed a significant contribution of hs-CRP to coronary risk prediction with better discrimination.